Abstract

FERNANDEZ, M.J.; LEAL, M.Á.  and  GUZMAN, J.. Appropriateness of treating glaucoma suspects: Concordancy study with the RAND study group. Arch Soc Esp Oftalmol [online]. 2010, vol.85, n.5, pp.174-178. ISSN 0365-6691.

Objective: The Appropriateness of Treating Glaucoma Suspects Study Group proposes to identify which patients suspected of glaucoma are suitable for treatment. Our objective is to analyse the concordance between our clinical decisions and this Study Group. Methods: Retrospective study of 77 patients (39 suspects, 38 ocular hypertensives). Variables such as age, family history, intraocular pressure, disc size, cup-to-disc ratio, central corneal thickness and life expectancy were collected. They were scored following the Appropriateness of Treating Glaucoma Suspects Scale. Whether there was a consensus to treat or not depended on this value. The kappa index was used to measured the concordancy. Results: The kappa index was 0.082 (95% confidence interval between -0.11 and 0.27). Total concordancy was obtained in 41 patients (63,08%). We decided to treat 25 patients (22 of which were not treated by the experts) and not to treat 40 patients (2 of which were treated by the experts). In 12 patients there was noconsensus by the experts to treat, but we decided to treat 8 of them. Conclussions: The concordancy index was low. Others variables such as visual fields and Heidelberg Retina Tomography (HRT III) parameters were not collected by the experts but were important in our decisions. There are no clinical guidelines on suspects. Individualised decisions are still necessary.

Keywords : Glaucoma suspect; Ocular hypertension; Risk factors; Open-angle glaucoma; Intraocular pressure.

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