Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial

Gazzard, Gus; Konstantakopoulou, Evgenia; Garway-Heath, David; Garg, Anurag; Vickerstaff, Victoria; Hunter, Rachael; Ambler, Gareth; Bunce, Catey; Wormald, Richard; Nathwani, Neil; Barton, Keith; Rubin, Gary S.; Buszewicz, Marta; Bourne, Rupert; Broadway, David C; Davis, Alison; Jayaram, Hari; Jiang, Yuzhen; Lim, Siak Piang; Liput, Joanna; Manners, T D; Morris, Stephen; Strouthidis, Nicholas G.; Wilson, Sarah; Zhu, Haogang

doi:10.1016/s0140-6736(18)32213-x

Cited by 356 publications

(343 citation statements)

References 33 publications

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“…e LIGHT trial was a randomized controlled trial with 36 months of follow-up comparing selective laser trabeculoplasty (n � 356) to drops (n � 362) in treatment-naïve patients. Eyes of patients in the selective laser trabeculoplasty group were within target intraocular pressure at more visits (93·0%) than in the eye drops group (91·3%) [31]. In addition, selective laser trabeculoplasty was more cost-effective in the United Kingdom compared to drops.…”

Section: Laser and Minimally Invasive Glaucoma Surgery To Improve Adhmentioning

confidence: 94%

“…Multiple studies on laser trabeculoplasty and minimally invasive glaucoma surgery (MIGS) procedures have been published in the recent years. Recently, the LIGHT study got published [31]. e LIGHT trial was a randomized controlled trial with 36 months of follow-up comparing selective laser trabeculoplasty (n � 356) to drops (n � 362) in treatment-naïve patients.…”

Section: Laser and Minimally Invasive Glaucoma Surgery To Improve Adhmentioning

confidence: 99%

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Influence of Cost of Care and Adherence in Glaucoma Management: An Update

Meier-Gibbons

Töteberg‐Harms

2020

Journal of Ophthalmology

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e costs for glaucoma care are rising worldwide. e main reason is the increase of life expectancy and the increasing variety of diagnostic tests and therapeutically options by implants and devices. How can we influence the increase in costs? Does a relationship exist between the rising costs and the behavior of patients especially in regard to adherence of patients to the prescribed therapy? Are there ways to improve adherence? e costs of a disease can be estimated by adding the direct costs and the indirect costs deriving from the disease. Many studies have been looking at the direct costs, for example, the costs of diagnostic tests and treatment modalities. Unfortunately, not many studies investigated the indirect costs, i.e., costs related to the need of a person to accompany the patient during his or her outpatient visits or the costs deriving from loss of work capacity because of the disease itself or the outpatient visits. Adherence or the synonym compliance has been discussed since many years, and it seems that it remains a major problem in the management of many chronic diseases. Despite all efforts to improve adherence, the adherence rate in chronic diseases such as glaucoma or arterial hypertension remains considerably low. One of the main factors in improving adherence is raising patient's awareness of the disease by providing general understanding of their disease. Other important factors are simplified therapeutic regimens, e.g., fixed combination drops, sustained drug release techniques, or new glaucoma surgical procedures with a more favorable risk profile.

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Section: Laser and Minimally Invasive Glaucoma Surgery To Improve Adhmentioning

confidence: 94%

Section: Laser and Minimally Invasive Glaucoma Surgery To Improve Adhmentioning

confidence: 99%

Influence of Cost of Care and Adherence in Glaucoma Management: An Update

Meier-Gibbons

Töteberg‐Harms

2020

Journal of Ophthalmology

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“…Participants were 50 adults aged 18-40 years (32 female; mean [standard deviation] age: 25 [5] years) with normal or correct-to-normal vision. All participants completed both tests twice.…”

Section: Participantsmentioning

confidence: 99%

“…Traditional clinical measures of basic visual function, such as visual acuity (VA), do not necessarily reflect the patient's experience, or the impact of vision loss on patients' lives . As a result, patient‐reported outcome measures (PROMs) are often used as secondary outcome measures (and sometimes as primary outcome measures) in ophthalmic clinical trials . However, discrepancies have been found between self‐reports and actual performance on real world tasks .…”

Section: Introductionmentioning

confidence: 99%

“…1 As a result, patient-reported outcome measures (PROMs) are often used as secondary outcome measures (and sometimes as primary outcome measures) in ophthalmic clinical trials. [2][3][4][5] However, discrepancies have been found between self-reports and actual performance on real world tasks. [6][7][8] Moreover, perceived problems with visual function might be influenced by other factors, such as an individual's lifestyle or personality.…”

Section: Introductionmentioning

confidence: 99%

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Refinement and preliminary evaluation of two tablet‐based tests of real‐world visual function

Jones

Tigchelaar

Demaria

et al. 2019

Ophthalmic Physiologic Optic

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Purpose To describe, refine, evaluate, and provide normative control data for two freely available tablet‐based tests of real‐world visual function, using a cohort of young, normally‐sighted adults. Methods Fifty young (18–40 years), normally‐sighted adults completed tablet‐based assessments of (1) face discrimination and (2) visual search. Each test was performed twice, to assess test‐retest repeatability. Post‐hoc analyses were performed to determine the number of trials required to obtain stable estimates of performance. Distributions were fitted to the normative data to determine the 99% population‐boundary for normally sighted observers. Participants were also asked to rate their comprehension of each test. Results Both tests provided stable estimates in around 20 trials (~1–4 min), with only a further reduction of 14%–17% in the 95% Coefficient of Repeatability (CoR95) when an additional 40 trials were included. When using only ~20 trials: median durations for the first run of each test were 191 s (Faces) and 51 s (Search); test‐retest CoR95 were 0.27 d (Faces) and 0.84 s (Search); and normative 99% population‐limits were 3.50 d (Faces) and 3.1 s (Search). No participants exhibited any difficulties completing either test (100% completion rate), and ratings of task‐understanding were high (Faces: 9.6 out of 10; Search: 9.7 out of 10). Conclusions This preliminary assessment indicated that both tablet‐based tests are able to provide simple, quick, and easy‐to‐administer measures of real‐world visual function in normally‐sighted young adults. Further work is required to assess their accuracy and utility in older people and individuals with visual impairment. Potential applications are discussed, including their use in clinic waiting rooms, and as an objective complement to Patient Reported Outcome Measures (PROMs).

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Glaucoma in Adults—Screening, Diagnosis, and Management

Stein

Khawaja

Weizer

2021

JAMA

280

131

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ImportanceGlaucoma is the most common cause of irreversible blindness worldwide. Many patients with glaucoma are asymptomatic early in the disease course. Primary care clinicians should know which patients to refer to an eye care professional for a complete eye examination to check for signs of glaucoma and to determine what systemic conditions or medications can increase a patient’s risk of glaucoma. Open-angle and narrow-angle forms of glaucoma are reviewed, including a description of the pathophysiology, risk factors, screening, disease monitoring, and treatment options.ObservationsGlaucoma is a chronic progressive optic neuropathy, characterized by damage to the optic nerve and retinal nerve fiber layer, that can lead to permanent loss of peripheral or central vision. Intraocular pressure is the only known modifiable risk factor. Other important risk factors include older age, nonwhite race, and a family history of glaucoma. Several systemic medical conditions and medications including corticosteroids, anticholinergics, certain antidepressants, and topiramate may predispose patients to glaucoma. There are 2 broad categories of glaucoma, open-angle and angle-closure glaucoma. Diagnostic testing to assess for glaucoma and to monitor for disease progression includes measurement of intraocular pressure, perimetry, and optical coherence tomography. Treatment of glaucoma involves lowering intraocular pressure. This can be achieved with various classes of glaucoma medications as well as laser and incisional surgical procedures.Conclusions and RelevanceVision loss from glaucoma can be minimized by recognizing systemic conditions and medications that increase a patient’s risk of glaucoma and referring high-risk patients for a complete ophthalmologic examination. Clinicians should ensure that patients remain adherent with taking glaucoma medications and should monitor for adverse events from medical or surgical interventions used to treat glaucoma.

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Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial

Cited by 356 publications

References 33 publications

Influence of Cost of Care and Adherence in Glaucoma Management: An Update

Influence of Cost of Care and Adherence in Glaucoma Management: An Update

Refinement and preliminary evaluation of two tablet‐based tests of real‐world visual function

Glaucoma in Adults—Screening, Diagnosis, and Management

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