What We Have Learned From the Ocular Hypertension Treatment Study

Am J Ophthalmol. 2018 May:189:xxiv-xxvii. doi: 10.1016/j.ajo.2018.02.016. Epub 2018 Mar 1.


Purpose: To identify results from the Ocular Hypertension Study that can aid patients and clinicians to make evidence-based decisions about the management of ocular hypertension.

Design: Perspective.

Results: At 60 months, the cumulative frequency of developing primary open-angle glaucoma (POAG) was 4.4% in the medication group and 9.5% in the observation group (hazard ratio for medication, 0.40; 95% confidence interval [CI], 0.27-0.59; P < .0001). At 13 years the cumulative proportion of participants who developed POAG was 0.22 (95% CI 0.19-0.25) in the original observation group and 0.16 (95% CI 0.13-0.19) in the original medication group (complementary log-log x2P = .009). A 5-factor model (older age, higher IOP, thinner central corneal thickness, larger cup-to-disc ratio, and higher visual field pattern standard deviation) separated participants at high and low risk of developing POAG.

Conclusions: Clinicians and patients can make evidence-based decisions about the management of ocular hypertension using the risk model and considering patient age, medical status, life expectancy, and personal preference.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Antihypertensive Agents / therapeutic use
  • Disease Progression
  • Evidence-Based Medicine
  • Glaucoma, Open-Angle / diagnosis
  • Glaucoma, Open-Angle / etiology
  • Glaucoma, Open-Angle / physiopathology
  • Humans
  • Intraocular Pressure / physiology
  • Life Expectancy
  • Ocular Hypertension / complications
  • Ocular Hypertension / drug therapy*
  • Ocular Hypertension / physiopathology
  • Proportional Hazards Models
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Secondary Prevention
  • Vision Disorders / drug therapy
  • Vision Disorders / physiopathology
  • Visual Fields / drug effects


  • Antihypertensive Agents