Early Manifest Glaucoma Trial (EMGT)

Early Manifest Glaucoma Trial (EMGT)

Purpose: To compare the effect of immediately lowering the IOP vs. no treatment or later treatment on the progression of newly detected open-angle glaucoma.


–       Large randomized clinical trial to compare glaucoma progression in initially treated vs. late or untreated patients with newly detected open angle glaucoma

–       Will allow measurement of immediate IOP lowering treatment on progression during the followup period

–       255 patients (50-80yrs) were enrolled and randomized to treatment with Betaxolol and ALT or to no initial treatment

–       Pts were followed for a minimum of 4 yrs, seen every 3 months.

–       Pts in treated group received Xalatan if IOP >25, untreated group Xalatan if IOP>35; if still high then individualized treatment.

–       Study outcome is glaucoma progression based on HVF analyses and disc photographs


–       It showed considerable benefits of treatment that significantly delayed progression of glaucoma

Teaching points:

Initiate treatment for glaucoma ASAP once confirmed.