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The Ocular Hypertension Treatment Study
Topical Medication Delays or Prevents Primary Open-angle Glaucoma in African American Individuals
Eve J. Higginbotham, MD;
Mae O. Gordon, PhD;
Julia A. Beiser, MS;
Michael V. Drake, MD;
G. Richard Bennett, OD;
M. Roy Wilson, MD;
Michael A. Kass, MD; for the Ocular Hypertension Treatment Study Group
Arch Ophthalmol. 2004;122:813-820.
Background The prevalence of glaucoma is higher in African American individuals than in white individuals.
Objective To report the safety and efficacy of topical ocular hypotensive medication in delaying or preventing the onset of primary open-angle glaucoma (POAG) among African American participants in the Ocular Hypertension Treatment Study.
Methods Eligibility criteria included age between 40 and 80 years, intraocular pressure between 24 and 32 mm Hg in one eye and between 21 and 32 mm Hg in the other eye, and no evidence of glaucomatous structural or functional damage by standard clinical measures. Participants were randomized to either the observation group or medication group. Of the 1636 participants randomized, 408 were self-identified as African American.
Main Outcome Measure The primary outcome was the development of reproducible visual field abnormality and/or reproducible optic disc deterioration attributed to POAG.
Results Among African American participants, 17 (8.4%) of 203 in the medication group developed POAG during the study (median follow-up, 78 months) compared with 33 (16.1%) of 205 participants in the observation group (hazard ratio, 0.50; 95% confidence interval, 0.28-0.90; P = .02).
Conclusion Topical ocular hypotensive therapy is effective in delaying or preventing the onset of POAG in African American individuals who have ocular hypertension.
From the Department of Ophthalmology, Maryland Center for Eye Care Associates, Baltimore (Dr Higginbotham); the Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Mo (Drs Gordon, Beiser, and Kass); the University of California San Francisco, Oakland (Dr Drake); Pennsylvania College of Optometry, Philadelphia (Dr Bennett); and Texas Tech University Health Sciences Center, Lubbock (Dr Wilson). A complete list of members of the Ocular Hypertension Treatment Study is available at https://vrcc.wustl.edu. The authors have no relevant financial interest in this article.
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