Surveillance of Glaucoma Medical Therapy in a Glasgow Teaching Hospital: 26 Years Experience
- 1 Tennent Insttitute of Ophthalmology, Glasgow, United Kingdom;
- 2 Glasgow Royal Infirmary, United Kingdom
- To whom correspondence should be addressed. E-mail: donald.montgomery{at}northglasgow.scot.nhs.uk
- Received 8 October 2008
- Accepted 23 April 2009
- Published Online First 23 July 2009
Abstract
Aims: To report the initial findings of a unique database of 956 patients with ocular hypertension (OHT), normal tension glaucoma (NTG), and primary open angle glaucoma (POAG) attending the Glaucoma Clinic of Glasgow Royal Infirmary.
Method: The database contains retrospective data from 1981, and prospective data from 1999. Analyses have been carried out using specially written queries to generate reports relating to prescription trends and reasons for treatment discontinuation.
Results: Numbers of patients: POAG: 580, OHT: 242, NTG: 134. Of 2928 treatment change episodes recorded, failure to reach or maintain a target IOP accounted for 51.9%, while adverse effects accounted for 22.1%. Latanoprost use increased sharply since 1996, and brimonidine, betaxolol and dorzolamide, use has declined significantly. Bimatoprost had a higher rate of discontinuation due to adverse effects (25%) than travoprost (16.3%), or latanoprost (12.4%), but this was only statistically significant between latanoprost and bimatoprost (p=0.0038). In 2000 the database informed the introduction of a new treatment protocol that resulted in a fall in discontinuations due to adverse effects by almost two thirds.
Conclusion: A large and unique treatment database has been established at the Glaucoma Clinic of Glasgow Royal Infirmary. Containing data spanning a 26 year period, it promises to be an invaluable resource for audit and research and has already demonstrated its worth by informing changes in prescribing practice that have resulted in direct patient benefit.
