Daily eye drops hold key to glaucoma prevention

Main Category: Public Health
Article Date: 15 Jun 2004 - 7:00 PDT

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Glaucoma, a leading cause of blindness, may be delayed or prevented in high-risk African Americans with daily eye drops.

The findings, published in this month's issue of the Archives of Ophthalmology, also draw attention to the need for African Americans, beginning at age 40, to receive periodic eye exams to detect signs of the disease.

Although glaucoma has no early symptoms, it insidiously can lead to vision problems. The disease is caused by increased pressure inside the eye that builds up over time and damages the optic nerve, eventually causing blindness if not treated.

The study is the first large-scale and long-term analysis that shows the benefit of eye drops that lower intraocular pressure in delaying or preventing the disease, particularly in African Americans, according to Paul Weber, a principal investigator of the study. Only commercially available, physician-prescribed eye drops were used in the study.

"We now have data that demonstrates the significant difference in outcome that eye drops can make," said Weber, who chairs The Ohio State University Medical Center's Department of Ophthalmology. In the study, researchers found eye drops reduced the development of primary open-angle glaucoma in African Americans by nearly 50 percent.

The study initially followed approximately 1,600 people with elevated eye pressure. The group included 408 African Americans between the ages of 40 and 80 who had elevated eye pressure, but no signs of glaucoma. Half of the 408 were assigned daily pressure-lowering eye drops and the other half received no eye drops or other medical intervention.

In the group that received medication, the number of African Americans developing glaucoma was reduced by almost half: 8.4 percent compared to 16.1 percent who developed glaucoma in the group that received no medical intervention.

Results of the study do not imply that every African American with high eye pressure requires treatment, according to Dr. Eve Higginbotham, chair of the University of Maryland Medical Center's Department of Ophthalmology and an author of the study. She said extent of eye damage and the patient's general health are among factors to be considered before prescribing treatment.

Blacks are more than three times as likely as whites to acquire glaucoma. Family history, earlier onset of the disease as compared to other races, and economic and social barriers can contribute to increased prevalence of the disease in African Americans.

Increased eye pressure inside the eye is often associated with open-angle glaucoma. As clear fluid flows in and out of a chamber near the front of the eye, it nourishes the nearby tissues. A buildup of fluid and pressure occurs when the fluid passes too slowly through the chamber.

The Ocular Hypertension Treatment Study was funded by the National Eye Institute and the National Center on Minority Health and Health Disparities. Both are components of the National Institutes of Health.

The study was supported by Research to Prevent Blindness and Merck Research Laboratories. Although Merck is a manufacturer of eye drops, researchers at the 22 study sites were not limited to using specific medications.

Contact: David Crawford, Medical Center Communications, 614-293-3737, or crawford-1@medctr.osu.edu