Consensus statements define options for glaucoma medical therapy

S. Fabian Lerner

PARIS — Prostaglandin analogues are recommended as first-line treatment for most glaucoma cases, with IOP-lowering effect the definitive comparative efficacy for an ocular hypotensive agent, a clinician said here.

S. Fabian Lerner, MD, outlined the latest consensus statements from the World Glaucoma Association for selection of glaucoma medical therapy. The consensus examined when and how initial, adjunctive and combination therapy should be used for glaucoma treatment.

"This is part of the consensus on medical treatment on glaucoma," he said at the World Glaucoma Congress. "IOP reduction with initial monotherapy should be at least 20% from baseline, and less than 10% is considered as a non-response."

If therapy does not reach target IOP, adjunctive therapy is indicated, Dr. Lerner said. Fixed combinations should be used when possible, while surgery is indicated in cases in which medical therapy cannot maintain lowered IOP, progression is a serious risk or adherence is an issue.

"Comments to the statements [include] lowering IOP is the only proven treatment to halt or delay visual field loss and progression. Therapy with eye drops remains the preferred initial treatment in most cases," he said.

Disclosure: Dr. Lerner is a consultant for Alcon, Merck and Sidus.