The Monocular Trial: Does Response to Glaucoma Therapy in One Eye Predict Response in the Fellow Eye?

by Chaudhary, Omar Rehman

Abstract (Summary)
Purpose: To study if the intraocular pressure (IOP) change observed after starting a glaucoma medication in one eye is predictive of the change in IOP observed in the fellow eye once the same medication is used in both eyes.

Methods: In a retrospective study, 55 patients with glaucoma underwent monocular drug trials with various medications before the drug was added to the second eye. The change in IOP of the first treated eye during monocular therapy was compared with the IOP change of the second eye during binocular therapy. Relative changes in IOP of each eye were calculated by subtracting the change in IOP of the fellow eye from the treated eye.

Results: The IOP of the first eye decreased 5.8 ± 6.1 mmHg (mean ± standard deviation) during monocular therapy and the IOP of the second eye decreased 3.4 ± 5.7 mmHg during binocular therapy. The absolute IOP changes in the first and second eyes were poorly correlated (r = 0.095, p = 0.49). When relative changes in IOP were used, the first eye decreased 6.3 ± 5.3 mmHg and the second eye 4.2 ± 4.5 mmHg. The relative changes were well correlated (r = 0.404, p = 0.002). Excellent correlation was noted in the subset of glaucoma suspect patients when using absolute IOP changes (r = 0.590, p = 0.001).

Conclusions: The data supports that the absolute response of one eye to a medication is predictive of the future response of the fellow eye to the same medication in patients with glaucoma suspect, but not in the overall glaucoma population. If one uses one eye as a control when assessing the efficacy of a drug in the fellow eye, then the response of one eye to a glaucoma medication is predictive of the response of the fellow eye.

Bibliographical Information:

Advisor:Ron Afshari Adelman, MD

School:Yale University

School Location:USA - Connecticut

Source Type:Master's Thesis

Keywords:glaucoma ophthalmology intraocular pressure iop drug therapy


Date of Publication:02/11/2008

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