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The Monocular Trial

Omar Chaudhary, MD; Ron A. Adelman, MD, MPH; M. Bruce Shields, MD

Arch Ophthalmol. 2008;126(9):1216-1220.

Objective  To evaluate whether the change in intraocular pressure (IOP) observed in one eye after starting a glaucoma medication regimen is predictive of the change in IOP due to the same medication in the fellow eye.

Methods  A retrospective medical record review of 22 patients with primary open-angle glaucoma (POAG) and 27 glaucoma suspects who underwent monocular drug trials before the drug was added to the second eye. The absolute change in IOP from baseline and the relative change (change in treated eye minus change in fellow eye) in the first eye treated were compared with the second eye after binocular treatment.

Results  The absolute and relative decreases in IOP of the first eye were poorly correlated with those of the second eye in patients with POAG (r² < 0.001; P = .97 and r² = 0.040; P = .38, respectively). However, they were well correlated in glaucoma suspects (r² = 0.348; P = .001 and r² = 0.396; P < .001, respectively).

Conclusions  The change in IOP of one eye due to a medication may be predictive of the subsequent response of the fellow eye to the same medication in glaucoma suspects, but not in patients with POAG. Using the fellow eye as a control may confer a more accurate portrayal of the true therapeutic effects of a medicine, although further study is needed to support both of these findings.

Author Affiliations: Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut.

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RELATED LETTERS

Studies of Monocular Trials of Glaucoma Medications: Conflicting Results Explained by Varying Methods
Christopher T. Leffler
Arch Ophthalmol. 2009;127(5):707-708.
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Studies of Monocular Trials of Glaucoma Medications: Conflicting Results Explained by Varying Methods—Reply
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Studies of Monocular Trials of Glaucoma Medications: Conflicting Results Explained by Varying Methods
Leffler
Arch Ophthalmol 2009;127:707-708.
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Studies of Monocular Trials of Glaucoma Medications: Conflicting Results Explained by Varying Methods--Reply
Chaudhary et al.
Arch Ophthalmol 2009;127:708-708.
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