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Pearls from the EGS Guidelines
Pearls from the EGS Guidelines
The Ocular Hypertension Treatment Study (OHTS)

Publishing date: December 2019

Pearls Manager: Andrew Tatham

The OHTS was a multicentre randomised clinical trial designed to study the effect of topical ocular hypotensive medication in delaying or preventing the onset of glaucoma in OHT. Patients were randomised to medical treatment or no treatment. The goal of treatment was to lower IOP to < 24 mmHg and by at least 20% from baseline.
After 5 years, 4.4% of treated patients had develop glaucoma versus 9% of controls, a 50% reduction in risk. Risk factors for progression included thinner CCT, higher IOP, disc haemorrhages, older age, larger cup-to-disc ratio and worse pattern standard deviation (PSD). Disc haemorrhages detectable on photographs had been missed at 87% of clinical examinations.

EGS Guidelines, 4th edition, Page 16.

1. Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 2002; 120:701-13.
2. Budenz DL, Anderson DR, Feuer WJ, et al. Detection and prognostic significance of optic disc hemorrhages during the ocular hypertension treatment study. Ophthalmology 2006; 113:2137-43.

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