Diagnosis and management of chronic open angle glaucoma and by The National Collaborating Centre for Acute Care

By The National Collaborating Centre for Acute Care

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Extra info for Diagnosis and management of chronic open angle glaucoma and ocular hypertension:Methods, Evidence & Guidance

Sample text

1 Recommendations on diagnosis of patients with OHT, COAG or suspected COAG ¾ At diagnosis offer all people who have COAG, who are suspected of having COAG or who have OHT all of the following tests: • IOP measurement using Goldmann applanation tonometry (slit lamp mounted) • central corneal thickness (CCT) measurement • peripheral anterior chamber configuration and depth assessments using gonioscopy • visual field measurement using standard automated perimetry (central thresholding test) • optic nerve assessment, with dilatation, using stereoscopic slit lamp biomicroscopy with fundus examination.

The group met every 6-8 weeks during the development of the guideline. At the start of the guideline development process all GDG members declared interests including consultancies, fee-paid work, share-holdings, fellowships and support from the healthcare industry. At all subsequent GDG meetings, members declared arising conflicts of interest, which were also recorded (Appendix B). Members are either required to withdraw completely or for part of the discussion if their declared interest makes it appropriate, however this was not deemed necessary for any group members on this guideline.

Questions on provision of information for patients What are the most effective ways of providing information to patients? 3 Outcomes We looked for the following primary outcomes: • COAG progression defined as visual field defect progression and/or increased optic nerve damage. • Conversion to COAG in ocular hypertensive patients. Since all treatments aim to reduce the risk of progression by lowering IOP we looked for a link between IOP reduction and protection against progression. Two scenarios were considered: firstly a link between IOP reduction and reduced progression of established COAG, and secondly a link between IOP reduction and reduced conversion from OHT to COAG.

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