Inconsistency of the published definition of ocular hypertension.

PURPOSE: To examine the variability and to evaluate the influence of the Ocular Hypertension Treatment Study (OHTS) on the criteria for published definition of ocular hypertension (OH). DESIGN: Systematic literature review. METHODS: All articles about OH published between January 1995 and July 2005 from the 3 clinical journals of ophthalmology were identified by a literature search. They were reviewed to determine the criteria used to define OH, including intraocular pressure and central corneal thickness, visual field and optic disc assessment. RESULTS: There were 133 studies published on OH during the period under study. As a goal of the current study was to evaluate the influence of the publication of the OHTS results on the definition of OH used in the literature, all reports from the OHTS and its ancillary studies (n = 11) were excluded from the main analysis. After the exclusion of the OHTS reports, a total of 122 studies were used in the analysis. The intraocular pressure cut-off level used for OH diagnosis ranged from 18 to 26 mm Hg, with a mode of 22 mm Hg (49.2%). Only 13.1% of the articles reported central corneal thickness, and these were distributed evenly during the 10-year period under study. Visual field assessment was reported by most of the studies (110; 90.2%), but only 45% of them defined the criteria to classify a field as normal or glaucomatous. Further, only 37 of the 57 articles that reported the method of optic disc assessment described the criteria used to classify optic discs. CONCLUSIONS: The criteria used to define OH during the past 10 years have been highly variable. This wide variation suggests the important need for a standardized definition of OH.

Duke Scholars

Author Felipe Medeiros Ophthalmology, Glaucoma