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

描述（由申请人提供）：多达1000万40岁以上的美国人由于高眼压而有发展为青光眼的风险，但这1000万人中估计只有240万人每年发展为POAG的风险为bb0.2 %，从而达到开始低血压治疗的成本-效果阈值。挑战在于从75%的治疗不具有成本效益的人群中确定需要治疗的25%的“风险”个体。我们的预测模型是基于高眼压治疗研究（OHTS）和欧洲青光眼预防研究（EGPS）中未治疗组（n= 1319名参与者）的汇总数据，计算高眼压患者5年发生原发性开角型青光眼（POAG）的风险。这个预测模型可以在我们的互动“风险计算器”网站上找到，这个网站在不到一年的时间里吸引了来自72个国家的8000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。迄今为止，包括我们的预测模型在内，都没有为临床医生和患者提供基于证据的指导，以降低根据患者基线危险因素调整的不同目标眼压（mmHg）下青光眼风险（目的1）。拟议研究的具体目的是：目的1。确定IOP降低对POAG发生风险的影响。我们还将确定根据CCT调整IOP是否会提高POAG发展预测模型的精度。目标2。确定与眼高血压患者随访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有所提高。通过在我们的网站上放置出版物的链接或PDF副本，以及在基于网络的交互式风险计算器上包含目标治疗IOPs的计算，将加快研究结果转化为临床实践。分析数据集将包括OHTS和EGPS治疗组和未治疗组，共N=2,614名参与者，中位随访时间为5.5年，260例POAG。这些数据集已经去识别和统一，以便可以进行拟议的分析。OHTS和EGPS指导委员会已经批准了合作分析。

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.