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Related Concept Videos

Glaucoma: Overview01:25

Glaucoma: Overview

599
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
599
Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

459
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
459
Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

536
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
536

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Related Experiment Video

Updated: Jul 12, 2025

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
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Validating Trend-Based End Points for Neuroprotection Trials in Glaucoma.

Giovanni Montesano1,2, David F Garway-Heath2, Alessandro Rabiolo3,4

  • 1City, University of London, Optometry and Visual Sciences, London, UK.

Translational Vision Science & Technology
|October 31, 2023
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Summary

Trend-based visual field progression methods demonstrated superior power in detecting treatment effects compared to event-based methods. These findings suggest trend-based approaches are more efficient for evaluating glaucoma treatments.

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Area of Science:

  • Ophthalmology
  • Clinical Trials
  • Statistical Analysis

Background:

  • Evaluating visual field (VF) progression is crucial for assessing glaucoma treatment efficacy.
  • Current US Food and Drug Administration (FDA)-accepted methods rely on event-based criteria.
  • The power of trend-based progression detection methods remains less understood compared to event-based approaches.

Purpose of the Study:

  • To compare the statistical power of trend-based VF progression end points against FDA-accepted event-based end points.
  • To evaluate the efficiency of trend-based methods in detecting simulated treatment effects in glaucoma.

Main Methods:

  • Analyzed VF data from 3352 patients with a median follow-up of 11 years.
  • Simulated 2-year trial series (1000 iterations) with neuroprotective treatment effects.
  • Assessed linear mixed model (LMM) and time-to-progression (TTP) trend-based methods against FDA-7 and GPA-like event-based criteria.

Main Results:

  • Trend-based methods (LMM and TTP) showed significantly higher power than event-based methods.
  • None of the event-based methods achieved 80% power in detecting progression.
  • All evaluated methods maintained a 5% false-positive rate.

Conclusions:

  • Trend-based methods are efficient and powerful for detecting treatment effects defined by long-term, FDA-compatible progression.
  • These findings support the utility of trend-based analyses in clinical trials for glaucoma.