[Update on prospective glaucoma intervention studies].

BACKGROUND

Previously published prospective therapeutic intervention studies in ocular hypertension and glaucoma are summarized.

MATERIAL AND METHODS

The concept of intraocular pressure reduction was evaluated in normal tension glaucoma ["Early manifest glaucoma trial (EMGT)"], the "Collaborative normal-tension glaucoma study (CNTGS)" and ocular hypertension ["Ocular hypertensive study (OHTS)" as well as the "European glaucoma prevention study (EGPS)"]. Early open angle glaucoma patients were included in the EMGT trial as well as the "Collaborative initial glaucoma treatment study (CIGTS)", whereas advanced glaucoma patients were examined in the "Advanced glaucoma intervention study (AGIS)".

RESULTS

The study design, the results and the conclusions will be highlighted in the text.

CONCLUSIONS

The therapeutic concept of intraocular pressure reduction decreases the risk of progression by 50 % in normal tension glaucoma, ocular hypertension and early open angle glaucoma. The mean pressure reduction to 12 mmHg in advanced glaucoma abolished visual field progression. The natural course of the disease documented by the control groups is now known. Sensitive glaucoma progression detection is clinically available by glaucoma change probability maps (Humphrey-full threshold perimetry) used in the EMGT.