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FOLLOW-UP INTRAOCULAR PRESSURE AND THE RISK OF DEVELOPING PRIMARY OPEN-ANGLE GLAU

后续眼内压和发生原发性开角型青光眼的风险

基本信息

批准号：
7892455
负责人：
MAE O GORDON
金额：
$ 18.11万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2013-07-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): As many as 10 million Americans over the age of 40 years are at risk for developing glaucoma because of ocular hypertension, but only 2.4 million of these 10 million are estimated to have a >2% annual risk of developing POAG and thus meet the cost-effectiveness threshold to initiating hypotensive treatment. The challenge is to identify the 25% of the "at risk" individuals for whom treatment is indicated from the 75% for whom treatment is not cost-effective. Our prediction model which calculates the 5-year risk of developing primary open angle glaucoma (POAG) in individuals with ocular hypertension is based on the pooled data of the untreated arms (n=1,319 participants) of the Ocular Hypertension Treatment Study (OHTS) and the European Glaucoma Prevention Study (EGPS). This prediction model is available on our interactive "risk calculator" web site which has attracted more than 8,000 unique visitors from 72 countries in less than a year. We would like to increase the predictive accuracy and clinical utility of this risk calculator. No prediction model to date, including ours, gives clinicians and patients evidence-based guidance on the reduction of glaucoma risk at various target IOPs (in mmHg) adjusted for the patient's baseline risk factors (Aim 1). The Specific Aims of the proposed study are: Aim 1. To determine the impact of IOP reduction on the risk of developing POAG. We will also determine whether adjusting IOP for CCT increases the precision of the prediction model for development of POAG. Aim 2. To identify baseline factors associated with follow-up IOP (treated and untreated) in ocular hypertensive individuals. Aim 3. To determine if the predictive accuracy of the existing OHTS/EGPS baseline prediction model for the development of POAG is increased by including information on follow-up IOP level, trend or variability. Translation of research findings into clinical practice will be accelerated by placing a link or PDF copy of publications on our website and by including the calculation of target treatment IOPs on the web-based interactive risk calculator. The analysis dataset will include both treated and untreated groups in OHTS and EGPS, a total of N=2,614 participants with a median follow-up of 5.5 years and 260 cases of POAG. The datasets have already been de-identified and harmonized so that the proposed analyses can be undertaken. The Steering Committees of the OHTS and EGPS have approved the collaborative analyses.

描述（由申请人提供）：多达1000万40岁以上的美国人因高眼压而有患青光眼的风险，但这1000万人中估计只有240万人每年患POAG的风险>2%，因此符合开始治疗的成本效益阈值。目前的挑战是从75%的治疗不具有成本效益的“高危”人群中确定25%的治疗对象。我们的预测模型计算了高眼压个体发生原发性开角型青光眼（POAG）的5年风险，该模型基于高眼压治疗研究（OHTS）和欧洲青光眼预防研究（EGPS）的未治疗组（n= 1，319例受试者）的汇总数据。这一预测模型可在我们的互动式“风险计算器”网站上查阅，该网站在不到一年的时间里吸引了来自72个国家的8，000多名独立访问者。我们希望提高这种风险计算器的预测准确性和临床实用性。到目前为止，包括我们的预测模型在内，还没有为临床医生和患者提供基于证据的指导，以降低患者基线风险因素调整后的各种目标IOP（mmHg）下的青光眼风险（目标1）。本研究的具体目标是：目标1。确定IOP降低对POAG发生风险的影响。我们还将确定调整CCT的IOP是否会提高POAG发展预测模型的精度。目标2.确定与高眼压患者随访IOP（治疗和未治疗）相关的基线因素。目标3.通过纳入随访IOP水平、趋势或变异性信息，确定现有OHTS/EGPS基线预测模型对POAG发展的预测准确性是否增加。通过在我们的网站上放置出版物的链接或PDF副本，并通过在基于网络的交互式风险计算器上包括目标治疗IOP的计算，将加速研究结果转化为临床实践。分析数据集将包括OHTS和EGPS的治疗组和未治疗组，共N= 2，614例受试者，中位随访时间为5.5年，260例POAG病例。这些数据集已经被去识别化和协调，以便可以进行拟议的分析。OHTS和EGPS的指导委员会已批准了合作分析。