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首页> 外文期刊>Journal of glaucoma >Applying the recent clinical trials on primary open angle glaucoma: the developing world perspective.
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Applying the recent clinical trials on primary open angle glaucoma: the developing world perspective.

机译：将最新的临床试验应用于原发性开角型青光眼：发展中国家的观点。

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ABSTRACT:: Recent clinical trials have provided scientific guidelines for the treatment of ocular hypertension and primary open angle glaucoma. The developing world need to apply these trials in a sensible and cost effective manner. The number needed to treat (NNT) attempts to tailor treatment to the individual patient. The NNT for the average ocular hypertensive is 20. Those with intraocular pressure >/=26 mm Hg have an NNT of 6. Restricting treatment to those with lower central corneal thickness and or high cup disc ratios can further lower NNT and make treatment more cost effective. The NNT for the average patient with early POAG is 5. Targeting those at higher risk for progression, (bilateral POAG, higher IOP and or pseudo-exfoliation) can further reduce NNT. As far as the modality of treatment is concerned, provided quality can be ensured, collaborative initial glaucoma treatment study (CIGTS) could be interpreted to justify primary surgery in the developing world context.Population attributable risk percentage (PAR), a measure that reflects the public health importance of a disease was used to extrapolate results to the overall population. Ocular hypertension has an "effective" PAR of 8.5%, a value not considered high enough to warrant public health intervention. POAG had an "effective" PAR of 16%, perhaps high enough to be considered a public health problem and justify inclusion as a target disease in the Vision 2020 program. However the logistics and opportunity costs of diagnosis and treatment would probably prevent inclusion of POAG in public health budgets of most developing countries.
机译：摘要：：最近的临床试验为高眼压和原发性开角型青光眼的治疗提供了科学指导。发展中国家需要以明智且具有成本效益的方式进行这些试验。需要治疗的次数（NNT）尝试针对个别患者量身定制治疗方案。平均眼压性高血压的NNT为20。眼压> / = 26 mm Hg的患者的NNT为6。将治疗限制在中央角膜厚度较低和/或高杯盘比率的患者中可进一步降低NNT，使治疗费用更高有效。对于患有早期POAG的普通患者，其NNT为5。针对那些具有较高进展风险的患者（双侧POAG，更高的IOP和/或假性剥脱）可以进一步减少NNT。就治疗方式而言，只要可以确保质量，就可以将协作性初始青光眼治疗研究（CIGTS）解释为在发展中世界背景下进行初次手术的理由。人口归因风险百分比（PAR）反映了疾病对公共卫生的重要性被用来将结果推算到总体人群中。高眼压症的“有效” PAR为8.5％，该值被认为不足以值得公共卫生干预。 POAG的“有效” PAR为16％，可能足够高，可以被认为是公共卫生问题，并有理由将其纳入2020年愿景计划的目标疾病。但是，诊断和治疗的后勤和机会成本可能会阻止将POAG纳入大多数发展中国家的公共卫生预算中。

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