Do We Conform with European Glaucoma Society Guidelines in the Medical Treatment of Primary Open-Angle Glaucoma/Ocular Hypertension? Data from a Real-Life Practice.

ABSTRACT

Purpose: To evaluate the prescribing habits of glaucoma specialists and of general ophthalmologists, and reveal the conformance with European Glaucoma Society (EGS) guidelines in the medical treatment of primary open-angle glaucoma (POAG) and ocular hypertension (OHT). Methods: Patients receiving medical treatment for POAG/OHT in the glaucoma clinic comprised the "naive group." Patients having a diagnosis and a treatment for POAG/OHT initiated in another center before presentation comprised the second group and were named as "treatment initiated elsewhere" (TIEW). All patients were retrospectively evaluated from the patients' charts. The outcome measures included the percentage of eyes treated with monotherapy, the molecule groups preferred, and the change in prescription trends over the years in both groups. Results: Seventy-two subjects were included in the naive group and 135 subjects in TIEW group. The rate of monotherapy was 76% and 36% in both groups, respectively. The molecule number was significantly higher in the TIEW group compared with naive group (1.98 ± 0.89 vs. 1.28 ± 0.56, P < 0.001). Until 2003, beta blockers, and in the 2003-2008 period, prostaglandin analogs (PGAs) were the mostly prescribed drugs in glaucoma clinic. From 2009, the rate of PGAs declined, with PGAs being replaced by combination drugs and alfa-2 agonists. Conclusions: Overtreatment rate was high among patients receiving a diagnosis and a treatment by general ophthalmologists, whereas glaucoma specialists were found to conform with EGS guidelines. A shift toward polypharmacy was observed from 2000 to 2017. The common guidelines to evaluate and treat glaucoma need to be adopted by the general ophthalmologists in their real-life practice.