Background/aims The aim of this study was to validate the Glaucoma Risk Stratification Tool (GLAUC-STRAT-fast) currently recommended by the Royal College of Ophthalmologists for the risk stratification of patients with glaucoma in the UK National Health Service Hospital Eye Service.
Methods GLAUC-STRAT fast was applied to the LiGHT trial participants by risk-stratifying the worse eye of each patient at baseline and after 3 years of treatment. Metrics of disease severity or treatment intensity used for the validation were: increased number of monitoring visits or treatment escalations; needing a trabeculectomy; a reduction of >2 dB in visual field mean deviation (VF MD) during the monitoring period; identification of rapid VF loss on total (TD) and/or pattern deviation (PD). The proportion of eyes within each baseline stratum for each of the above markers was compared against the other strata, using a χ2 test for proportions.
Results There was an association between the baseline stratification and the number of treatment escalations needed to maintain the eye-specific target intraocular pressure (p=0.001), the number of visits needed throughout the 3-year follow-up period (p=0.001), the need for trabeculectomy (p<0.001) and absolute loss of MD over the course of the monitoring period (p<0.001). The rate of VF progression was not associated with baseline risk stratification for TD or PD progression (p≥0.007, with Bonferroni correction).
Conclusion The GLAUC-STRAT fast tool is a useful tool for risk stratifying eyes with ocular hypertension or open angle glaucoma. Further research is needed to confirm and validate its applicability to more advanced glaucomas and generalisability to clinical use.
Trial registration number The LiGHT trial is registered at controlled-trials.com (ISRCTN32038223).
- Intraocular pressure
- Optic Nerve
Data availability statement
No data are available.
Data availability statement
De-identified participant data from the LiGHT trial may be available from Professor Gus Gazzard (https://orcid.org/0000-0003-1982-5005) pending appropriate research ethics approvals.
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Contributors EK designed the work acquired and analysed data, interpreted the results and wrote the manuscript. AK designed the work acquired and analysed data, interpreted the results and revised the manuscript. HJ and GG conceived and designed the work, interpreted the results and revised the manuscript. HJ is responsible for the overall content of the manuscript as the guarantor.
Funding This work was funded by Moorfields Eye Charity (GR001214).
Competing interests GG is the president-elect of UKEGS. This work was funded by Moorfields Eye Charity (GR001214).
Provenance and peer review Not commissioned; externally peer reviewed.