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Screening for primary open-angle glaucoma in the primary care setting: an update for the US preventive services task
Craig Fleming1, Evelyn P Whitlock, Tracy Beil
1Oregon Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland 97227, USA. craig.fleming@kp.org
Annals of Family Medicine
|March 31, 2005
Summary
Screening for early primary open-angle glaucoma (POAG) in asymptomatic individuals shows potential treatment benefits for delaying vision loss. However, more research is needed to confirm effectiveness and improve quality of life outcomes.
Area of Science:
- Ophthalmology
- Public Health
Background:
- Primary open-angle glaucoma (POAG) is a significant cause of irreversible blindness.
- Early detection and intervention are crucial for managing POAG and preventing vision-related disability.
Purpose of the Study:
- To review the effectiveness of screening for and treating early POAG in asymptomatic individuals.
- To evaluate the impact of early POAG treatment on visual field progression and quality of life.
Main Methods:
- Systematic review of studies identified through MEDLINE, Cochrane Library, and expert consultation.
- Articles were graded using US Preventive Services Task Force criteria.
- Analysis of two randomized controlled trials comparing treatment efficacy versus no treatment for early POAG.
Main Results:
- No randomized controlled trials on population screening for POAG were identified.
- One trial showed treatment reduced POAG progression by 17% (ARR) over 5 years (NNT=5.8).
- Another trial found no significant difference in progression between treated and untreated patients with early POAG and normal intraocular pressure.
Conclusions:
- Lowering intraocular pressure may delay visual field deficits in some asymptomatic POAG patients.
- The impact of delayed progression on vision-related function remains unclear.
- Further research on population screening is necessary to demonstrate improved functional outcomes and quality of life.