Relationship Between Intraocular Pressure and Primary Open Angle Glaucoma Among White and Black Americans

PurposeTo assess the efficacy and safety of different regimens, including monotherapy and double therapy, for primary open‐angle glaucoma (POAG) or ocular hypertension.MethodsWe searched PubMed, EMBASE and clinicaltrials.gov for studies that fit our inclusion criteria in this network meta‐analysis. Randomized controlled trials that report data on efficacy and safety of medications for POAG or ocular hypertension are included. Data on intra‐ocular pressure (IOP) lowering effect and incidence of adverse events including hyperaemia and ocular discomfort were extracted and used in mixed‐comparison analysis.ResultsThis study includes 72 randomized trials. Data were available on 12 medical treatments of POAG or ocular hypertension. Of 66 possible comparisons of outcome efficacy, 15 treatments were compared directly. Compared to prostaglandin analogues (PGA), beta‐blockers (BB) showed relatively weaker ability to lower IOP, followed by α2‐adrenergic agonists (AA) and carbonic anhydrase inhibitors (CAI). For dual therapy, regimens composed of a combination of PGA with another treatment demonstrated more powerful IOP lowering efficacy, while the combination of two non‐PGA drugs had lower efficacy in controlling IOP than PGA alone. There was no statistical significance in combinations that did not include PGA on efficacy of IOP control. In terms of tolerance, PGA alone leads to more severe hyperaemia than any other monotherapy regimen, while BBs have the lowest effect on the incidence of hyperaemia. Most dual therapy regimens containing PGA also lead to serious hyperaemia, with the exception of PGA + AA. Compared to regimens containing PGA, those with BB are less likely to cause hyperaemia.ConclusionOur network meta‐analysis showed that PGAs provide best IOP lowering effect among all the monotherapy regimen. Combination of PGA and other category of drugs leads to better IOP decrease. Combination of BB and another non‐PGA drug may have less ocular side‐effects than PGA alone.

show abstract

“…Reduction of IOP both decreases the incidence rate of POAG and delays progression of POAG (Sommer et al. 1991; Heijl et al. 2002; Kass et al.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of different regimens for primary open‐angle glaucoma or ocular hypertension: a systematic review and network meta‐analysis

Huang

Zhang

2017

Acta Ophthalmologica

View full text Add to dashboard Cite

show abstract

“…The fact that glaucoma is more prevalent and occurs at a younger age in blacks lends some credence to this theory. [34][35][36][37] The AGIS investigators conclusions were that 'planning and analysis of further studies of glaucoma treatment should take race into account'. 38 The assumption that blacks from the Caribbean, Europe, America, and Africa all have the same disease process and reaction to surgery because of a shared ancestry is likely to be incorrect.…”

Section: Introductionmentioning

confidence: 99%

A review of trabeculectomy in East Asian people—the influence of race

Husain

Clarke

Seah

et al. 2004

Eye

View full text Add to dashboard Cite

Glaucoma is the leading cause of irreversible blindness worldwide. East Asians account for approximately half of all glaucoma sufferers. It is likely that trabeculectomy will be needed for many of these people as the intraocular pressure is to be maintained at a satisfactorily low level. The eyes of East Asian people differ in some aspects from those of other races. This review describes the natural history of the eye after trabeculectomy in East Asians.

show abstract

“…15 Among the world's ethnic populations, OAG is least prevalent among Europeans, somewhat more prevalent in Hispanics 6 and Indians, 16 and affects Africans 5 and African-derived groups most. 3,17 The age-specific prevalence of OAG among black persons is four times greater than that of white persons. This difference is most likely to have a genetic basis, as the prevalence of OAG in Tanzanian villagers and black residents of East Baltimore, USA is quite similar, despite huge differences in diet, culture, environment, and health care delivery.…”

Section: Prevalence Of Glaucomamentioning

confidence: 99%

“…This dramatic change in thinking came from the clinical observations of Drance and others, as well as the population-based data from the Baltimore survey 3 and many other studies, presented in the 1996 Doyne Lecture by Alfred Sommer. 4 Persons in population-based surveys who have disc and field findings meeting the OAG criteria suggested by Foster et al have untreated IOP in the normal range for their ethnic groups about half the time.…”

Section: Definition Of Oag: Normal Tension Glaucoma Is Deadmentioning

confidence: 99%

New paradigms in the mechanisms and management of glaucoma

Quigley

2004

Eye

View full text Add to dashboard Cite

During the last 30 years, the definition of glaucoma as been revised to eliminate the inclusion of intraocular pressure. Open angle glaucoma is the second leading cause of blindness in the world, but the proportion of those with the disease who become blind is low. Diagnostic methods for glaucoma need improvement. The pathogenetic steps to loss of neurons in glaucoma are increasingly understood and nonpressure lowering therapies are on the horizon.

show abstract

Relationship Between Intraocular Pressure and Primary Open Angle Glaucoma Among White and Black Americans

Cited by 1,066 publications

References 19 publications

Efficacy and safety of different regimens for primary open‐angle glaucoma or ocular hypertension: a systematic review and network meta‐analysis

Efficacy and safety of different regimens for primary open‐angle glaucoma or ocular hypertension: a systematic review and network meta‐analysis

A review of trabeculectomy in East Asian people—the influence of race

New paradigms in the mechanisms and management of glaucoma

Contact Info

Product

Resources

About