A 60-year-old woman with primary open-angle glaucoma (POAG) has target IOP of 15 mmHg. Despite maximum tolerated medical therapy (timolol + dorzolamide + latanoprost), IOP remains 20 mmHg. The Advanced Glaucoma Intervention Study (AGIS) demonstrated that IOP consistently below which threshold was associated with no visual field progression?

• A 14 mmHg
• B 18 mmHg
• C 22 mmHg
• D 10 mmHg ✓

Explanation

The AGIS trial showed that patients whose IOP was maintained consistently below 10 mmHg had essentially no visual field deterioration over 7 years. Eyes with higher IOPs showed progressive field loss proportional to the degree of elevation. This finding underpins the concept of 'low-teen' or sub-10 target IOP in advanced glaucoma. AGIS also established that ALT first followed by trabeculectomy was better in White patients, while trabeculectomy first was better in Black patients.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.