Quantifying the effect of intraocular pressure reduction on the occurrence of glaucoma

A Peeters, CA Webers, MH Prins, Maurice Zeegers, F Hendrikse, JS Schouten

    Research output: Contribution to journalReview article

    16 Citations (Scopus)


    PURPOSE: To estimate the effect of reducing intraocular pressure (IOP) on: (i) the incidence of primary open-angle glaucoma (POAG) in patients with ocular hypertension (OH), and (ii) the progression of glaucoma. METHODS: A meta-analysis of relevant randomized controlled trials was conducted. A literature search was performed to identify trials with: a randomized comparison of IOP-lowering intervention versus placebo or no treatment; visual field loss or optic disc changes as outcome; and follow-up >6 months. A pooled relative risk (RR) was calculated by a random effects model. Risk reduction of glaucoma conversion per mmHg of IOP reduction was quantified in a meta-regression model. RESULTS: We identified nine OH and one POAG trials. A meta-analysis of OH trials gives a pooled RR of 0.61 [95% confidence interval (CI) 0.45-0.83]. A meta-regression shows a decrease of the RR of glaucoma conversion by 14% with each mmHg extra IOP reduction (P = 0.045). No meta-analysis of POAG trials was performed because only one study has been identified. CONCLUSION: There is sufficient evidence that OH therapy reduces the risk of conversion to glaucoma. This risk reduction increases with greater IOP reduction.
    Original languageEnglish
    Pages (from-to)5-11
    Number of pages7
    JournalActa ophthalmologica
    Issue number1
    Publication statusPublished - 1 Feb 2010


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