A New Tool to Predict Glaucoma

Glaucoma can be difficult to detect and diagnose. Measurement of eye pressure, examination of the optic nerve, and visual field testing, in particular, are simple, painless tests that help to determine if a patient has glaucoma.

Recently, a new tool has become available to eye care specialists to help predict the development of glaucoma in one type of patient, namely one with ocular hypertension (high eye pressure).

Risk Calculator

Researchers at the Hamilton Glaucoma Center of the University of California San Diego (UCSD) have developed a “glaucoma risk calculator” that estimates the 5-year risk of a patient with ocular hypertension progressing to glaucoma.

The risk calculator was developed based on a comparison of data collected in the UCSD Diagnostics in Innovations in Glaucoma Study (DIGS) from patients with ocular hypertension and compared with the data obtained independently in the national multi-center Ocular Hypertension Treatment Study (OHTS).

This recent study validated key patient risk factors that predict the progression from ocular hypertension to glaucoma - risk factors such as older age, high intraocular pressure, thin central cornea, larger vertical cup-to-disc ratio, and higher visual field pattern standard deviation index.

The risk calculator provides the eye specialist with a single number that estimates the risk for developing glaucoma within the next five years of an individual patient. To simplify the predictive model for clinical use, the UCSD team developed an easy-to-use slide rule-type device known as the STAR (Scoring Tool for Assessing Risk).

Use of a risk calculator may improve allocation of healthcare resources and provides information that helps an eyecare specialist manage a patient with ocular hypertension.

As an example, it may be recommended that a patient who is at low risk for developing glaucoma be withdrawn from treatment and examined at less frequent intervals. In contrast, treatment might be recommended to another patient who is at high risk for developing glaucoma.

Use of a risk calculator provides information that can help patients understand their condition, but is not meant to replace the experience and clinical judgment of an eye specialist. As new data become available, it is likely that new and improved risk calculators will emerge. These calculators may incorporate new risk factors or eliminate others to improve their predictive abilities.

The Glaucoma Research Foundation and other national organizations dedicated to eye health encourage everyone at risk to have regular comprehensive eye examinations by an eye care specialist. This is particularly important for those at highest risk, such as those with ocular hypertension or a family member with glaucoma.

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Article by Robert N. Weinreb, MD, Distinguished Professor of Ophthalmology and Director of the Hamilton Glaucoma Center at the University of California, San Diego. He and Felipe Medeiros, MD, his colleague at UCSD, are co-developers of the STAR glaucoma risk calculator.

Last reviewed on March 05, 2011

This article appeared in the September 2006 issue of Gleams. Subscribe

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