Online risk calculator will guide in management of ocular hypertension

Based on data from the Ocular Hypertension Treatment Study (OHTS), researchers have identified five risk factors that can be used to predict which patients with ocular hypertension will develop open-angle glaucoma. From this data they have developed a risk calculator that should be available online soon, according to Michael A. Kass, MD, professor and chairman of ophthalmology and visual sciences at the Washington University School of Medicine, St. Louis.

"We know that lowering IOP will decrease the incidence of glaucoma by more than 50%," Dr. Kass said. "However, we don't treat all patients with elevated pressure. We manage them with risk stratification."

He spoke to the media during the American Academy of Ophthalmology annual meeting.

The five risk factors for glaucoma in patients with ocular hypertension are:

• Increased IOP.

• Older age.

• Thinner central corneal thickness.

• Increased cup-to-disc ratio.

• Increased PSD on a Humphrey visual field test.

"This predictive calculator will be available on the Web and will help determine low-risk and high-risk patients," said Dr. Kass, who was the principal investigator and study chairman of the OHTS, sponsored by the National Institutes of Health.

"The patient benefit will be that those who most need treatment will receive it," he said. "It will likely decrease the number of patients on medications."

Other glaucoma experts covered diagnostic tools; glaucoma treatments, such as SLT versus medications and glaucoma filtering surgery; sleep apnea and glaucoma; and driving and peripheral vision loss.

Donald L. Budenz, MD, MPH, professor of ophthalmology, epidemiology, and public health at the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, moderated the session.