Related Experiment Videos
Evolution of first-line glaucoma therapy, 2007-2018: a population-based analysis.
Katharine Doliszny1, Matthew P Quinn1, Sherif R El-Defrawy2
1Department of Ophthalmology, Queen's University, Kingston, ON; Department of Ophthalmology, Kingston Health Sciences Centre, Kingston, ON.
Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|December 9, 2022
Summary
Laser trabeculoplasty is now the most common first-line glaucoma therapy for older Ontarians. While ophthalmologists lead treatment, optometrists are increasingly involved in managing glaucoma with medications like prostaglandin analogues.
Area of Science:
- Ophthalmology
- Public Health
- Health Services Research
Background:
- Glaucoma is a leading cause of irreversible blindness.
- First-line glaucoma therapy (FLGT) management has evolved with changes in provider roles and treatment options.
- Understanding long-term trends in FLGT is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To analyze the long-term trends in first-line glaucoma therapy (FLGT) initiated by ophthalmologists and optometrists in Ontario.
- To compare the utilization of medical treatments versus laser trabeculoplasty (LT) as initial FLGT.
- To assess the evolving role of optometrists in glaucoma management.
Main Methods:
- Retrospective population-based study utilizing provincial healthcare databases.
- Inclusion of 194,759 Ontario residents aged 66 years or older who received FLGT between 2007 and 2018.
- Calculation of rates for medical treatments (prostaglandin analogue [PGA], beta-blocker, alpha-2-agonist, carbonic anhydrase inhibitor) and LT, alongside provider-specific rates.
Main Results:
- Laser trabeculoplasty (LT) surpassed medical treatments as the most common FLGT by 2015.
- Prostaglandin analogue (PGA) therapy was initially most common, but LT became the predominant FLGT.
- Ophthalmologists provided the majority (94.6%) of FLGT, but optometrists' medication prescription rates increased significantly.
Conclusions:
- Laser trabeculoplasty (LT) is now the most frequent first-line glaucoma therapy for older adults in Ontario.
- Prostaglandin analogues (PGAs) remain the most prescribed glaucoma medication.
- Optometrists are contributing a growing proportion of FLGT, particularly after gaining prescribing privileges.