Medical decision, persistence of initial treatment, and glaucoma progression in a Brazilian reference hospital

Arquivos Brasileiros de Oftalmologia

Jayter Silva Paula¹  José Afonso Ramos Filho¹  Daniel Felipe Alves Cecchetti¹  Daniela Tiemi Nagatsuyu¹  Maria De Lourdes Veronese Rodrigues¹  Eduardo Melani Rocha¹ 

[1] ,São Paulo University Ribeirão Preto School of Medicine Department of Ophthalmology, Otorhinolaryngology, and Head and Neck SurgeryRibeirão Preto SP ,Brazil

关键词: Glaucoma;    open-angle;    Intraocular pressure;    Blindness;    Attitude to health;    Communication;    Patient compliance;    Physician-patient relations;    Disease progression;    Glaucoma de ângulo aberto;    Pressão intraocular;    Cegueira;    Atitude frente a saúde;    Comunicação;    Cooperação do paciente;    Relações médico-paciente;    Avanço da doença;   

DOI  :  10.1590/S0004-27492010000200008

来源: SciELO

【 摘 要 】

PURPOSE: To evaluate the initial medical decision regarding primary open-angle glaucoma (POAG) treatment in a referral center, and to assess the relationship between the persistence of treatment and the disease progression in cases managed exclusively with medication. METHODS: A retrospective chart review was performed for 65 patients with primary open-angle glaucoma referred to a tertiary hospital. The following clinical data were analyzed: initial medication, persistence of treatment, best corrected visual acuity, visual field mean deviation index, cup/disc ratio, and intraocular pressure. Patients were classified into four categories in order to verify the clinical evolution. RESULTS: The mean number of visits/ year was 4.4 ± 3.5, and the follow-up period was 40.7 ± 22.8 months. Mean persistence time was 12.9 ± 13.9 months. By six and twelve months, respectively, 39.1% and 62.5% of patients had discontinued the initially prescribed regimen, mainly by adding to (42%) or changing (26%) the course of treatment. Thirteen patients (21%) were reclassified to a worse category of primary open-angle glaucoma, however, despite this trend, no significant correlation was found between shorter persistence and primary open-angle glaucoma worsening. CONCLUSIONS: Persistence rates with initial therapy schemes were low, as measured by medical decisions to change the course of treatment. Therefore, improvement in the initial medical decision is crucial in order to offer a more stable and effective treatment for primary open-angle glaucoma.

【 授权许可】

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