Original articlesThe advanced glaucoma intervention study (AGIS): 7. the relationship between control of intraocular pressure and visual field deterioration☆
Section snippets
Materials and methods
The Advanced Glaucoma Intervention Study design and methods, described in detail elsewhere,16, 17, 18 are summarized here. Appropriate institutional review boards approved the Advanced Glaucoma Intervention Study protocol, and all enrolled patients provided informed consent.
To be eligible for the Advanced Glaucoma Intervention Study, patients had to be 35 to 80 years old and have open-angle glaucoma that could no longer be adequately controlled by medications alone. Eligible eyes had to be
Results
Table 2presents some baseline characteristics for each of the defined intraocular pressure groups for the 738 eyes in the Predictive Analysis. Some characteristics differ by assigned intervention sequence: the majority of eyes with intraocular pressure averaged over the first three 6-month visits of less than 14 mm Hg were in the trabeculectomy–argon laser trabeculoplasty–trabeculectomy sequence, and a majority of eyes in the 14 to 17.5 mm Hg and greater than 17.5 mm Hg groups were in the argon
Discussion
We undertook the present analyses to determine whether the achievement of low levels of intraocular pressure after surgical intervention in eyes of Advanced Glaucoma Intervention Study patients is associated with a slowing of visual field deterioration. We found from both the Predictive Analysis and Associative Analysis that low postintervention intraocular pressure is associated with reduced progression of visual field defect. Moreover, the association became stronger as follow-up lengthened.
Advanced Glaucoma Intervention Study Centers and Investigators: participating institutions, current investigators, and former investigators who participated for two or more years
Study Co-chairmen: Douglas E. Gaasterland, MD; Fred Ederer, MA, FACE
Acknowledgements
The authors thank Paul F. Palmberg, MD, PhD, Bascom-Palmer Eye Institute and member of the Advanced Glaucoma Intervention Study Policy and Treatment Effects Monitoring Board, for suggesting this investigation and for helpful comments on a draft of the manuscript.
References (22)
- et al.
Why do some people go blind from glaucoma?
Ophthalmology
(1982) - et al.
Correlation between intraocular pressure control and progressive glaucomatous damage in primary open-angle glaucoma
Am J Ophthalmol
(1991) - et al.
Early manifest glaucoma trialdesign and baseline data
Ophthalmology
(1999) Intraocular pressure and glaucoma
Am J Ophthalmol
(1989)The damage caused by pressure. XLVI Edward Jackson Memorial Lecture
Am J Ophthalmol
(1989)- et al.
Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans. The Baltimore Eye Survey
Arch Ophthalmol
(1991) - et al.
Risk factors for open-angle glaucoma. The Barbados Eye Study
Arch Ophthalmol
(1995) - et al.
Biostatistical analysis of the collaborative glaucoma study. I. Summary report of the risk factors for visual field defects
Arch Ophthalmol
(1980) Glaucomatous visual field loss and subnormal IOP
Visual field prognosis in advanced glaucoma
Acta Ophthalmol
(1987)
Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures
Am J Ophthalmol
Cited by (2522)
Clinical outcomes of Ahmed glaucoma valve implantation in primary open-angle glaucoma and pseudoexfoliative glaucoma
2024, International Ophthalmology
- ☆
This study was supported by grants from the National Eye Institute (grant numbers 2 UI0 EY06824 through 2 U10 EY06827, 2 U10 EY06830 through 2 U10 EY06835, 2 U10 EY07057, and 7 U10 EY09640) and the Office of Research on Minority Health. The two agencies are part of the National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland.
- 1
The writing team members for this paper are: Paul C. VanVeldhuisen, MS, Fred Ederer, MA, FACE, Douglas E. Gaasterland, MD, E. Kenneth Sullivan, PhD, Allen Beck, MD, Bruce E. Prum, Jr, MD, Marshall N. Cyrlin, MD, and Howard Weiss, MD, MPH. A complete list of participants in the Advanced Glaucoma Intervention Study appears at the end of this article.