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Physician: Treatment should begin as early as possible
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LAS VEGAS — Glaucoma progresses in more untreated patients than in patients who are given intraocular pressure-lowering medication, according to one clinician. “IOP-lowering treatment should be aggressive,” Louis B. Cantor, MD, said at the First Annual Ocular Surgery News Symposium — Glaucoma: Improving Your Odds.
He said that high IOP is not always associated with glaucoma; however, these patients are at an increased risk for glaucoma. He stressed that they should be treated if other risk factors are present. “You should always think about the long term,” he said.
Dr. Cantor stated that every 1 mm Hg counts when trying to lower IOP. He said that in one study, for every 1 mm Hg in IOP reduction at month 3, there was a 10% decrease in progression rates of the disease. He added that patients with a lower long-term mean IOP reduction had a 13% decrease in progression rate for every 1 mm Hg of IOP lowering.
When determining how aggressive a physician should be in treating the disease and how low the IOP should go, Dr. Cantor noted the American Academy of Ophthalmology recommends setting an initial target IOP reduction between 20% and 30%. He added lowering the IOP by 40% from baseline may be warranted if the patient shows optic nerve damage.
“Lower is always better,” he said.