No Recommendation on Benefits and Harms of Glaucoma Screening

MARCH 13, 2013
Jeannette Y. Wick, RPh, MBA, FASCP
Based on a review of almost 100 trials and studies, researchers determined that the available evidence was too limited to support or oppose primary open-angle glaucoma screening in adults.

The US Preventive Services Task Force (USPSTF) issued a Draft Recommendation Statement on February 19, 2013, stating that it cannot make a recommendation regarding the benefits and harms of screening for primary open-angle glaucoma in adults. The Draft Recommendation Statement is available for comment until March 18, 2013.
“Glaucoma is a very serious disease for many Americans, but gaps in the available evidence on the value of screening prevent us from making a recommendation,” task force co-vice chairman Albert Siu, MD, MPH, said in a news release.
In advance of its recommendation, the USPSTF asked researchers to review evidence regarding open-angle glaucoma treatments and their associated harms. The results were published in the February 19, 2013, edition of Annals of Internal Medicine. The researchers looked at whether laser, medical, or surgical treatments have been demonstrated to prevent or slow optic nerve damage and visual field loss. They also looked at these treatments’ ability to reduce visual impairment or to improve patient-reported outcomes.
The researchers analyzed 75 randomized, controlled trials and 24 observational studies. They concluded that no specific treatment option—surgical, medical, or laser—best prevented visual disability and improved patient-reported outcomes. They determined that the available evidence is simply too sparse and inconclusive to be certain.
In its draft statement, the task force identified a number of research needs. In particular, it indicated that research documenting patient-reported outcome and visual impairment should be a high priority.
The USPSTF, an independent panel of non-federal experts in prevention and evidence-based medicine, makes recommendations regarding a wide range of clinical preventive health care services. The task force is composed of primary care providers, including internists, nurses, and health behavior specialists.

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.

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