Clinical and Quality of Life Insights on Glaucoma from Analyses of CIGTS Data

描述(由申请人提供)：协作性初始青光眼治疗研究(CIGTS)是一项由国家眼科研究所支持的多中心临床试验，为新诊断的开角型青光眼应该如何治疗提供了独特的见解，无论是通过初始手术还是药物干预。尽管如此，在广泛的CIGTS数据资源中，仍有大量与青光眼及其治疗相关的临床相关和重要的信息尚未被开发。本拨款申请中所述的拟议数据分析的实施将提供独特的、具有成本效益的机会，以调查与开角型青光眼患者的管理和护理直接相关的其他研究问题。我们建议进行广泛的分析，以解决以下四个具体目标：具体目标1：评估满足预先设定的目标眼压(IOP)对长期控制视野丧失进展的影响。具体目的2：确定激光小梁成形术(ALT)的远期降眼压效果，包括初始治疗、人口学和临床因素所起的作用，以及ALT对视功能和生活质量的影响。具体目标3：确定在个人评估青光眼对其生活质量的个人负担时最重要的因素是什么。具体目标4：描述青光眼的症状归因或其治疗与其他原因随时间的变化，并探索与归因变化相关的临床和人口学因素。

DESCRIPTION (provided by applicant): The Collaborative Initial Glaucoma Treatment Study (CIGTS), a National Eye Institute supported multicenter clinical trial, provided unique insights to how newly diagnosed open-angle glaucoma should be treated, whether by initial surgical or medical intervention. Even so, a wealth of clinically-relevant and important information to glaucoma and its treatment remains un-tapped in the extensive CIGTS data resource. Conduct of the proposed data analyses described in this grant application will provide unique, cost-effective opportunities to investigate additional research questions that are directly relevant to the management and care of patients who have open-angle glaucoma. We propose to conduct extensive analyses that address the following four specific aims: Specific Aim 1: To evaluate the impact that meeting a pre-set target intraocular pressure (IOP) has on long-term control of progression in visual field loss. Specific Aim 2: To determine the long-term IOP-reducing effect of argon laser trabeculoplasty (ALT), including the role that initial treatment, demographics, and clinical factors play, and the impact ALT has on visual function and quality of life. Specific Aim 3: To determine what factors are most important in an individual's assessment of the personal burden of glaucoma on his/her quality of life. Specific Aim 4: To describe symptom attribution to glaucoma or its treatment vs. other causes over time and explore clinical and demographic factors associated with changes in attribution.