TY - JOUR
T1 - The advanced glaucoma intervention study (AGIS)
T2 - 4. Comparison of treatment outcomes within race: Seven-year results
AU - AGIS Investigators
AU - Gaasterland, Douglas E.
AU - Ederer, Fred
AU - Sullivan, E. Kenneth
AU - VanVeldhuisen, Paul C.
AU - Vela, M. Angela
AU - Weiss, Howard
AU - Brown, Reay H.
AU - Beck, Allen
AU - Lynch, Mary
AU - Leef, Donna
AU - Moore, Kathy
AU - Closek, John
AU - Marsh, Twyla
AU - Banks, Juanita
AU - Gunsby, Johnny
AU - Lober, Kathy
AU - Stepka, Candace
AU - Plavnieks, Suzanne
AU - Kellogg, Melissa
AU - Ashburn, Frank
AU - Schacht, Karen
AU - Burt, Elizabeth
AU - Coyle, Ellen
AU - Hundley, Mary
AU - Lauber, Susan
AU - Michelitsch, Karl
AU - Rae, Anne
AU - Vayer, Lynn
AU - Allen, Robert C.
AU - Sporn, Amy
AU - Hoyle, Sharon
AU - Fendley, C. Kay
AU - Weber, Paul A.
AU - Derick, Robert
AU - Mc-Kinney, Kathryne
AU - Moore, Diane
AU - Romans, Billi
AU - Baker, N. Douglas
AU - Kapetansky, Fred
AU - Lehmann, David
AU - Gloeckner, Becky
AU - Cassady, Mary
AU - Coleman, Kris
AU - Satterwhite, Yvonne
AU - Simmons, Lori
AU - Sharf, Lisa J.
AU - Harbin, Thomas S.
AU - Hooper, Montana
AU - Goldstein, Stacy
AU - Palmberg, Paul F.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1998/7/1
Y1 - 1998/7/1
N2 - Objective: The purpose of this report is to present separately for black and white patients with advanced glaucoma 7-year results of two alternative surgical intervention sequences. Design: A randomized controlled trial. Participants: A total of 332 black patients (451 eyes), 249 white patients (325 eyes), and IO patients of other races (13 eyes) participated. Potential follow-up ranged from 4 to 7 years. Intervention: Eyes were randomly assigned to either an argon laser trabeculoplasty (ALT)-trabeculectomytrabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence. The second and third interventions were offered after failure of the first and second interventions, respectively. Main Outcome Measures: Average percent of eyes with decrease of visual field (APDVF), average percent of eyes with decrease of visual acuity (APDVA), and average percent of eyes with decrease of vision (APDV) are the outcome measures. Decrease of visual field (DVF) is an increase from baseline of at least 4 points on a glaucoma visual field defect scale ranging from 0 to 20, decrease of visual acuity (DVA) is a decrease from baseline of at least 15 letters (3 lines), and decrease of vision (Dv) is the occurrence of either DVF or DVA. The averages are of percent decreases observed at 6-month intervals from the first 6-month visit to the end of the specified observation period. Results: In both black and white patients throughout 7-year follow-up, the mean decrease in intraocular pressure was greater in eyes assigned to TAT, and the cumulative probability of failure of the first intervention was greater in eyes assigned to ATT. In black patients, APDVF, APDVA, and APDV are less for the ATT sequence than for the TAT sequence throughout the 7 years. In white patients, APDVF also favors the ATT sequence but only for the first year, after which it favors the TAT sequence through the seventh year; APDVA also favors the ATT sequence, but the ATT-TAT difference progressively diminishes over 7 years; and APDV favors ATT over TAT initially, but after 4 years, the advantage switches to and remains with TAT. Conclusions: These data support use of the ATT sequence for all black patients. For white patients without life-threatening health problems, the data support use of the TAT sequence.
AB - Objective: The purpose of this report is to present separately for black and white patients with advanced glaucoma 7-year results of two alternative surgical intervention sequences. Design: A randomized controlled trial. Participants: A total of 332 black patients (451 eyes), 249 white patients (325 eyes), and IO patients of other races (13 eyes) participated. Potential follow-up ranged from 4 to 7 years. Intervention: Eyes were randomly assigned to either an argon laser trabeculoplasty (ALT)-trabeculectomytrabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence. The second and third interventions were offered after failure of the first and second interventions, respectively. Main Outcome Measures: Average percent of eyes with decrease of visual field (APDVF), average percent of eyes with decrease of visual acuity (APDVA), and average percent of eyes with decrease of vision (APDV) are the outcome measures. Decrease of visual field (DVF) is an increase from baseline of at least 4 points on a glaucoma visual field defect scale ranging from 0 to 20, decrease of visual acuity (DVA) is a decrease from baseline of at least 15 letters (3 lines), and decrease of vision (Dv) is the occurrence of either DVF or DVA. The averages are of percent decreases observed at 6-month intervals from the first 6-month visit to the end of the specified observation period. Results: In both black and white patients throughout 7-year follow-up, the mean decrease in intraocular pressure was greater in eyes assigned to TAT, and the cumulative probability of failure of the first intervention was greater in eyes assigned to ATT. In black patients, APDVF, APDVA, and APDV are less for the ATT sequence than for the TAT sequence throughout the 7 years. In white patients, APDVF also favors the ATT sequence but only for the first year, after which it favors the TAT sequence through the seventh year; APDVA also favors the ATT sequence, but the ATT-TAT difference progressively diminishes over 7 years; and APDV favors ATT over TAT initially, but after 4 years, the advantage switches to and remains with TAT. Conclusions: These data support use of the ATT sequence for all black patients. For white patients without life-threatening health problems, the data support use of the TAT sequence.
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U2 - 10.1016/S0161-6420(98)97013-0
DO - 10.1016/S0161-6420(98)97013-0
M3 - Article
C2 - 9663215
AN - SCOPUS:0031683717
VL - 105
SP - 1146
EP - 1164
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 7
ER -