Abstract

P 234

Treatment of difficult to treat patients with glaucoma or ocular hypertension: A survey with data of patients from 335 ophthalmologists in private practice

Thelen U.¹, Vorwerk C.², Buchholz P.^3
1Münster; ²Augenklinik der Otto-von-Guericke-Universität Magdeburg; ³Health Economics and Outcomes Research Allergan, Ettlingen

Objective: The importance of lowering IOP by medical treatment of Glaucoma and Ocular Hypertension is well established. AGIS demonstrated that a stabilization of visual field damage only was achieved if IOP was at 18 mmHg during a time period of 7 years. We conducted a survey of patients difficult to treat with OH and glaucoma using a standardized questionnaire in private practice in order to evaluate if the new findings regarding diagnosis, therapy and follow-up of patients with OH, POAG and other types of Glaucoma are already established and if yes to which extend.
Methods: 335 ophthalmologists in private practice participated in our survey. By using a standardised questionnaire including questions on diagnosis, type and severity of glaucoma and therapy, data of 786 patients with difficult to treat Glaucoma and OH were collected.
Results: Primary open angle glaucoma was the most frequent diagnosis (72%). 52.9% of all patients suffered for 5 years and more on their disease. Mean actual (treated) IOP for all patients was 20.8±4.0 mmHg, mean target IOP was 16.9±2.1mmHg. The actual (treated) IOP values followed a normal distribution (maximum: 20 mmHg). Most frequent target IOP value, chosen by the participants of the survey was 18mmHg (370 eyes). Disease severity was one factor influencing the choice of target IOP values: Mean target IOP for patients with ocular hypertension (n=110) was 18.5±2.1 mmHg whereas mean target IOP for patients with glaucomatous optic nerve head damage and visual field defects (n=390) was 16.4±2.1 mmHg. In 657 patients predefined target IOP values were not achieved. Overall up to 5 different drugs were prescribed for the same patient. The number of different drugs negatively impacted patient compliance.
Conclusions: Our results clearly show that the target IOP concept is widely established in day to day glaucoma management. One factor influencing the level of target IOP is the severity of the disease. Our results further suggest that within this difficult to treat population with OH and glaucoma a combination therapy is often required.

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