Lecture 11: Ocular Hypertension

Question 1

Define OHTN

Answer 1

IOP higher than 21mmHg and no damage to optic nerve, RNFL, or VF

Question 2

In OHTN, the patient must have (closed/open) angles

Answer 2

open

Question 3

__-__% of OHTN convert to glaucoma each year

Answer 3

1-2

Question 4

What was the result of the ocular hypertension study treatment? (OHTS)

Answer 4

• Mean IOP reduction in the treatment group was 22.5% vs 4% in the untreated group
• 5 year result
  
  • Treatment group - 4.4% reach glc endpoint
  • observation group - 9.5% reach glc endpoint

Question 5

What were the 5 major risk factors for POAG development?

Answer 5

• CCT per 40 micron thinner
• Vertical C/D per .10 larger
• PSD per 0.2 dB greater
• Age per decade
• IOP per mmHg

Question 7

What are risk calculates used for?

Answer 7

utilize algorithm for weighing and analyzing risk factors

Question 8

What is a point system from OHTS and EGPS used for?

Answer 8

allows estimation of conversion of OHT to glaucoma over 5 years

Question 9

When should OHTN therapy be initiated?

Answer 9

• When risk of 5% to 15 was present, this was seen as medorate & would have the recommendation of considering treatment
• A risk of 15% or higher was seen as high and would suggest a reccommending of treatment for these individuals

Question 11

A drop in 40um of corneal thickness equates about a __% higher chance of developing glaucoma

Answer 11

70%

• A person who has a pressure of 30 mmHg with a corneal thickness of 600um has half the glaucoma risk of someone who has a pressure of 20 mmHg - 10mmHg less - if that person alos has a corneal thickness of 500um
• In terms of glaucoma risk, the cornea is just as important a factor to consider as the IOP

Question 12

What if treatment is delayed in the OHTS study?

Answer 12

Delaying tratment does not affect the treatment results

Question 13

Who benefits most from treatment for OHTN?

Answer 13

Treatment benefits those at highest risk the most

Question 14

__ __ is an important property of the cornea that was NOT evaluated in the OHTS study.

• can be __x more predictive of glaucoma than CCT

Answer 14

Corneal hysteresis, 3x more predictive of glaucoma than CCT

Question 15

Each 1mmHg lower CH was associated with an increase of __% in the risk of developing glaucoma during follow up

Answer 15

21%

• CH was independently predictive of conversion to glc even when adjusted for age, IOP and CCT