{"id":703,"date":"2010-12-08T13:02:51","date_gmt":"2010-12-08T18:02:51","guid":{"rendered":"http:\/\/www.bu.edu\/?page_id=703"},"modified":"2010-12-08T13:07:44","modified_gmt":"2010-12-08T18:07:44","slug":"collaborative-initial-glaucoma-treatment-study-cigts","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/eye\/evidence-based-medicine\/glaucoma-studies\/collaborative-initial-glaucoma-treatment-study-cigts\/","title":{"rendered":"Collaborative Initial Glaucoma Treatment Study (CIGTS)"},"content":{"rendered":"

Collaborative Initial Glaucoma Treatment Study (CIGTS)<\/span><\/strong><\/p>\n

PURPOSE:<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 To compare the effectiveness of standard medical therapy versus filtration surgery to treat newly diagnosed open-angle glaucoma<\/p>\n

STUDY DESIGN:<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Randomized, controlled clinical trial<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 607 patients with newly diagnosed with open angle glaucoma were randomized to a medication treatment regimen or filtration surgery<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Medication regimen: topical medications starting with a one drug regimen with additional medications added if visual field loss progressed or if intraocular pressure remained elevated. If medications proved ineffective, the patient would undergo argon laser trabeculoplasty prior to trabeculectomy.<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Patients assigned to immediate filtration surgery would undergo trabeculectomy followed by ALT and medications, if surgery failed<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Follow up examinations occurred at community ophthalmologists and at Clinical Centers (month 3, 6 and biannual visits afterwards)<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Eligible patients were age 25 to 75 years old with IOP 20 mm Hg or greater and documented optic nerve damage and\/or visual field loss<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Other causes of glaucoma other than primary open-angle glaucoma, pigmentary glaucoma or pseudoexfoliation glaucoma were excluded.<\/p>\n

RESULTS:<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 At up to 5 years follow up, both groups had substantial\/sustained decrease in IOP<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Surgical group\u2019s IOPs ran 2-3 points lower than medication group<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Initially over first three years, surgical group had more VF and more VA loss. Difference disappeared after four\/five years<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Surgery group had more cataract extractions than the medical group.<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Both groups were satisfied with the quality of life associated with their treatment.<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Surgery group reported more eye symptoms over the first few years of follow up.<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Medical group reported inconsistent systemic symptoms<\/p>\n

TEACHING POINTS:<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No changes to current therapeutic approaches recommended based on initial data for treating OAG<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Given chronic, progressive nature of glaucoma, longer term follow-up is required to be able to further evaluate and recommend specific treatments<\/p>\n","protected":false},"excerpt":{"rendered":"

Collaborative Initial Glaucoma Treatment Study (CIGTS) PURPOSE: –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 To compare the effectiveness of standard medical therapy versus filtration surgery to treat newly diagnosed open-angle glaucoma STUDY DESIGN: –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Randomized, controlled clinical trial –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 607 patients with newly diagnosed with open angle glaucoma were randomized to a medication treatment regimen or filtration surgery –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Medication regimen: […]<\/p>\n","protected":false},"author":1980,"featured_media":0,"parent":700,"menu_order":2,"comment_status":"closed","ping_status":"open","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/pages\/703"}],"collection":[{"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/users\/1980"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/comments?post=703"}],"version-history":[{"count":5,"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/pages\/703\/revisions"}],"predecessor-version":[{"id":802,"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/pages\/703\/revisions\/802"}],"up":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/pages\/700"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/eye\/wp-json\/wp\/v2\/media?parent=703"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}