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Updated: May 18, 2026
07:11
Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
[Appropriateness of treating glaucoma suspects. Concordancy study with the RAND study group]
M J Fernández1, M Á Leal, J Guzmán
1Sección de Glaucoma, Hospital Virgen de La Salud, Toledo, España. mjfg05@gmail.com
Archivos De La Sociedad Espanola De Oftalmologia
|September 27, 2012
Summary
Clinical decisions for glaucoma suspects showed low agreement with the Appropriateness of Treating Glaucoma Suspects Scale. Individualized treatment decisions remain essential due to a lack of clear clinical guidelines.
Area of Science:
- Ophthalmology
- Clinical Decision-Making
- Glaucoma Research
Background:
- Glaucoma suspect management lacks standardized guidelines.
- The Appropriateness of Treating Glaucoma Suspects Study Group aimed to standardize treatment decisions.
- Evaluating concordance between clinical judgment and expert guidelines is crucial for patient care.
Purpose of the Study:
- To analyze the concordance between clinical decisions and the Appropriateness of Treating Glaucoma Suspects Scale.
- To assess the reliability of expert consensus in managing glaucoma suspects.
- To identify discrepancies in treatment recommendations for ocular hypertension and glaucoma suspects.
Main Methods:
- Retrospective study of 77 patients (39 glaucoma suspects, 38 ocular hypertensives).
- Collected variables included age, family history, intraocular pressure, and optic disc parameters.
- Scored patients using the Appropriateness of Treating Glaucoma Suspects Scale; concordance measured by the kappa index.
Main Results:
- Low concordance observed, with a kappa index of 0.082.
- Total agreement was achieved in 63.08% of patients.
- Significant discrepancies noted in treatment decisions compared to expert recommendations, particularly for patients without expert consensus.
Conclusions:
- The study highlights a low concordance between clinical decisions and the proposed scale.
- Omission of key diagnostic data (visual fields, HRT III) by experts impacted decision-making.
- The absence of clear clinical guidelines necessitates individualized treatment approaches for glaucoma suspects.
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