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Abstract #94971 Published in IGR 22-2

The glaucoma intensive treatment study: interim results from an ongoing longitudinal randomized clinical trial

Bengtsson B; Lindén C; Heijl A; Andersson-Geimer S; Andersson-Geimer S; Aspberg J; Aspberg J; Aspberg J; Jóhannesson G
Acta Ophthalmologica 2021; 0:

See also comment(s) by Tony Realini

PURPOSE: The aim of the study was to determine the perimetric rate of glaucoma progression in the ongoing Glaucoma Intensive Treatment Study (GITS) after 3 years of follow-up. DESIGN: This is a randomized, two-centre, prospective open-labelled treatment trial for open-angle glaucoma (OAG). PARTICIPANTS: The participants of this study were treatment-naive patients with newly diagnosed OAG, aged 46-78 years, with early to moderate glaucomatous visual field loss scheduled to be followed for 5 years within the study. METHODS: Patients were randomized to initial treatment with either topical monotherapy or with an intensive approach using drugs from three different classes, plus 360° laser trabeculoplasty. Changes in treatment were allowed. Standard automated perimetry and tonometry were performed and side-effects documented. All results are presented using intention-to-treat analysis. RESULTS: A total of 242 patients were randomized. After 3 years of follow-up, eight patients were lost to follow-up, six of whom were deceased. The median untreated baseline intraocular pressure (IOP) was 24 mmHg in both arms. The median IOP was almost constant over the 3 years of follow-up: ≈17 mmHg in the mono-arm and ≈14 mmHg in the multi-treatment arm. Treatment was intensified in 42% of the mono-treated patients and in 7% of the multi-treated patients. Treatment was reduced in 13% of the multi-treated patients. The median perimetric rate of progression was -0.5%/year in the mono-treated group and -0.1%/year in the multi-treated group (p = 0.03). CONCLUSION: The rate of disease progression was significantly slower in the multi-treated patients than in the mono-treated patients. Further follow-up will show whether this difference is sustained over time.

Department of Clinical Scien,ces in Malmö, Ophthalmology, Lund University, Lund, Sweden.

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11.1 General management, indication (Part of: 11 Medical treatment)
11.13.5 Other (Part of: 11 Medical treatment > 11.13 Combination therapy)
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)

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