Department of Ophthalmology, Maastricht University Hospital, The Netherlands.
Acta Ophthalmol. 2010 Feb;88(1):5-11. doi: 10.1111/j.1755-3768.2008.01452.x. Epub 2009 Apr 27.
To estimate the effect of reducing intraocular pressure (IOP) on: (i) the incidence of primary open-angle glaucoma (POAG) in patients with ocular hypertension (OH), and (ii) the progression of glaucoma.
A meta-analysis of relevant randomized controlled trials was conducted. A literature search was performed to identify trials with: a randomized comparison of IOP-lowering intervention versus placebo or no treatment; visual field loss or optic disc changes as outcome; and follow-up >6 months. A pooled relative risk (RR) was calculated by a random effects model. Risk reduction of glaucoma conversion per mmHg of IOP reduction was quantified in a meta-regression model.
We identified nine OH and one POAG trials. A meta-analysis of OH trials gives a pooled RR of 0.61 [95% confidence interval (CI) 0.45-0.83]. A meta-regression shows a decrease of the RR of glaucoma conversion by 14% with each mmHg extra IOP reduction (P = 0.045). No meta-analysis of POAG trials was performed because only one study has been identified.
There is sufficient evidence that OH therapy reduces the risk of conversion to glaucoma. This risk reduction increases with greater IOP reduction.
评估降低眼内压（IOP）对以下方面的影响：（i）高眼压症（OH）患者原发性开角型青光眼（POAG）的发病率，以及（ii）青光眼的进展。
对相关的随机对照试验进行了荟萃分析。进行了文献检索，以确定具有以下特征的试验：IOP 降低干预与安慰剂或无治疗的随机比较；视野丧失或视盘变化作为结果；随访时间>6 个月。通过随机效应模型计算汇总相对风险（RR）。通过荟萃回归模型量化了每降低 1mmHg IOP 可降低多少青光眼转化率的风险。
我们确定了 9 项 OH 试验和 1 项 POAG 试验。OH 试验的荟萃分析得出汇总 RR 为 0.61（95%置信区间 0.45-0.83）。荟萃回归显示，每降低 1mmHg IOP，青光眼转化率的 RR 降低 14%（P=0.045）。未对 POAG 试验进行荟萃分析，因为仅确定了一项研究。
有充分的证据表明 OH 治疗可降低向青光眼转化的风险。这种风险降低随着 IOP 降低而增加。
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