Ocular Hypertension Treatment Study 20-Year Follow-up: Chairman's Grant

 描述（由申请人提供）：原发性开角型青光眼（POAG）是美国和许多其他国家致盲的主要原因之一，也是非裔美国人致盲的主要原因。眼内压升高（高眼压或OHT）是POAG的主要危险因素，也是目前唯一可改变的危险因素。40岁以上的美国人口中有4-7%患有OHT。一个主要的公共卫生问题是如何应用以病人为中心的护理原则，并以有效和具有成本效益的方式管理这一大群人。OHTS仔细跟踪OHT参与者，平均时间为13年（OHTS 1期和2期）。这包括279名在研究期间发展为POAG的参与者，这是有史以来最大的POAG患者初始队列。我们建议在2015-2017年（OHTS第3阶段）重新检查所有20岁或以上的OHTS幸存者。我们将确定OHTS队列中POAG的发病率和严重程度，并确定与POAG相关的自我报告功能限制的频率和严重程度。我们还将开发一个20年的预测模型，用于根据OHT患者发生POAG的风险对OHT患者进行分层，并在发生POAG的患者中，开发一个视野丧失率的预测模型。OHTS第3阶段将使我们能够制定基于证据的20年OHT患者管理指南。这将有助于患者和临床医生就检查和测试的适当频率以及早期预防性治疗的益处做出明智的决定。知情决策应改善结果，降低成本，减轻患者和临床医生的负担。

 DESCRIPTION (provided by applicant): Primary open-angle glaucoma (POAG) is one of the leading causes of blindness in the United States and many other nations and is the leading cause of blindness in African Americans. Elevated intraocular pressure (ocular hypertension or OHT) is a major risk factor for developing POAG and the only modifiable risk factor at present. 4-7% of the United States population above age 40 has OHT. A major public health issue is how to apply the principles of patient- centered care and manage this large group of people in an effective and cost-effective manner. The OHTS carefully followed OHT participants for a median of 13 years (OHTS Phase 1 and 2). This includes 279 participants who developed POAG during the study, the largest inception cohort of POAG patients ever described. We propose to re-examine all surviving OHTS participants at 20 years or more in 2015-2017 (OHTS Phase 3). We will determine the incidence and severity of POAG in the OHTS cohort and determine the frequency and severity of self-reported functional limitations associated with POAG. We will also develop a 20-year prediction model for stratifying OHT patients by their risk of developing POAG and, among those who developed POAG, a prediction model for the rate of visual field loss. OHTS Phase 3 will allow us to develop evidence-based, 20-year guidelines for the management of patients with OHT. This will aid patients and clinicians to make informed decisions about the appropriate frequency of examinations and tests and the benefit of early, preventative treatment. Informed decisions should improve outcomes, reduce costs and reduce patient and clinician burden.