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Treatment of ocular hypertension

is it cost effective?

Tuulonen, Anja

Current Opinion in Ophthalmology: March 2016 - Volume 27 - Issue 2 - p 89–93
doi: 10.1097/ICU.0000000000000233
GLAUCOMA: Edited by Donald L. Budenz

Purpose of review The review evaluates the past 18-month literature related to cost–effectiveness of treating ocular hypertension (OHT) and give an opinion of the state of research.

Recent findings Three studies question the value of intensive monitoring in OHT and glaucoma. One study suggests that implementing Ocular Hypertension Treatment Study – European Glaucoma Prevention Study (OHTS-EGPS) risk prediction in every day practice overestimates the risk of open-angle glaucoma. While two models suggest that treating all intraocular pressures above 21 mmHg would be cost-saving (but disagree on the impact of this strategy on conversion to glaucoma), another study in turn suggests than we could safely reduce medications in almost half of the patients. Two studies suggest that effective early treatment could decrease follow-up costs in OHT and one modeling study suggests that using laser in preference to medication would be cost effective in glaucoma.

Summary The results of this time-limited review are confusing as they challenge many current beliefs to continue to do more than what we are currently doing. We have a huge gap in understating whether we are currently doing the ‘right’ things in our every day practices.

Tays Eye Centre, Tampere University Hospital, Tampere, Finland

Correspondence to Anja Tuulonen, MD, PhD, Tays Eye Centre, Tampere University Hospital PO BOX 2000, FI-33521 Tampere, Finland. Tel: +358 40 779 6278; e-mail:

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