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New guidelines focus on goals of therapy and treatment recommendations
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MAUI, Hawaii — A group of 17 glaucoma specialists have released preliminary guidelines that go above and beyond what the American Academy of Ophthalmology suggests, said one of the specialists here.
Anne L. Coleman, MD, PhD, told attendees at Hawaii 2003: the Royal Hawaiian Eye Meeting these guidelines are intended for the use of general ophthalmologists to supplement the AAO Preferred Practice Guidelines.
The guidelines define five groups of patients (mild, moderate, severe, normal-tension and glaucoma suspects). Each group is assigned an ideal target pressure or range of pressure that varies from a 25% to 35% reduction, depending upon classification.
“When deciding on a treatment, we concluded IOP lowering and patient safety were the two most important factors when prescribing medications,” she said.
In addition to setting IOP goals, medications for first-line, replacement and adjunctive therapies were agreed upon by the group for each of the five patient classes. Recommended medications include a once-daily hypotensive lipid for first-line treatment of glaucoma patients and suspects and alpha-adrenergic agonists and non-selective beta blockers for replacement therapy for these patients.
“We recommended once-daily hypotensive lipids because of their efficacy and safety,” she said. While there are some ocular side effects with these drugs, she emphasized that “there are no systemic side effects.”
Dr. Coleman said these guidelines will be more useful to the general ophthalmologist because they recommend specific classes of medications. All members of the American Glaucoma Society will be mailed a survey before the recommendations are finalized, she added.