_id

683a1628c782e11e38d1b228

id

10025

title

Ocular Hypertension Treatment Study (OHTS) Calculator

full_title

Ocular Hypertension Treatment Study (OHTS) Calculator

short_title

OHTS Calculator

med_description

Identifies patients that may benefit from therapy to lower intraocular pressure (IOP).

short_description

Primary open angle glaucoma prevention.

slug

ocular-hypertension-treatment-study-ohts-calculator

description

The Ocular Hypertension Treatment Study (OHTS) Calculator identifies patients that may benefit from intraocular pressure (IOP) lowering therapy.

keywords

Glaucoma, open-angle glaucoma, ocular hypertensive, OHTS, Ocular hypertension treatment study, POAG

complaint

[ "Vision Loss" ]

formula

Addition of the selected points: *Mean of three measurements per eye. **2 measurements per eye of: Humphrey full threshold 30-2, SITA Standard 30-2 or 24-2, or loss of variance from Octopus 32-2.

evidence

Ocular Hypertension Treatment Study (2002): This randomized controlled trial evaluated 1,636 patients with ocular hypertension without glaucomatous field or optic nerve loss and found that lowering IOP was beneficial in preventing the progression to glaucoma. This study also identified clinical characteristics that predict the onset of primary open angle glaucoma.

Data from the original OHTS group was pooled with data from the European Glaucoma Prevention Study (EGPS) group to develop with a model to predict five year progression to glaucoma based on characteristics identified in the original study.

The OHTS/EGPS model has been validated in subsequent studies referenced below.

measurements

[]

information

Interpretation:

refrences

{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/12049574 ", "text": "Kass MA, Heuer DK, Higginbotham EJ, et al. The Ocular Hypertension Treatment Study A Randomized Trial Determines That Topical Ocular Hypotensive Medication Delays or Prevents the Onset of Primary Open-Angle Glaucoma. Arch Ophthalmol. 2002;120(6):701–713. " } ], "Other References": [ { "href": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3117658/ ", "text": "The Ocular Hypertension Treatment Study Group, European Glaucoma Prevention Study Group. The Accuracy and Clinical Application of Predictive Models for Primary Open-Angle Glaucoma in Ocular Hypertensive Individuals. Ophthalmology. 2008; 115(11): 2030-2036." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/12049575 ", "text": "Gordon MO, Beiser JA, Brandt JD, et al. The Ocular Hypertension Treatment Study Baseline Factors That Predict the Onset of Primary Open-Angle Glaucoma. Arch Ophthalmol. 2002;120(6):714–720. " } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/17095090 ", "text": "Gordon MO. Ocular Hypertension Treatment Study Group, European Prevention Study Group. Validated prediction model for the development of primary open-angle glaucoma in individuals with ocular hypertension. Ophthalmology. 2007;114:10–9." } ], "Validations": [] }

pearls

• The original studies used patients with a baseline intraocular pressure (IOP) of 22 to 32 mmHg.

• Not validated in patients under 30 years of age or over 80 years of age.

• Primarily developed from studies looking at the early development of primary open angle glaucoma (POAG) and has little utility in later stages of glaucoma.

• Patients with potential secondary causes of elevated IOP including pigment dispersion or pseudoexfoliation should be excluded, as well as patients with non-glaucomatous reasons for visual field loss.

• There are other established risk factors for the development of POAG, and these should be taken into account separately.

usecase

Use in an outpatient setting in patients 30-80 years old with ocular hypertension to assess need for initial treatment to reduce the likelihood of progression to glaucoma.

reasons

Aids in shared decision making with patients regarding whether to initiate treatment for ocular hypertension based on the five-year risk of progression to open angle glaucoma.

next_advice

• Patients with a score between 0-6 can be observed every 6 months.

• Patients with a score between 7-12 should be counseled about the risks and benefits of starting treatment versus close observation.

• Patients with a score >12 should strongly consider initiating treatment.

next_actions

next_management

• Initiation of IOP lowering therapy.

• Close monitoring with visual field and optic nerve head imaging every 3-12 months, depending on specific patient parameters.

diseases

[ "Glaucoma" ]

input_schema

[ { "conditionality": "", "default": 0, "label_en": "Age, years", "mdcalc_info_concept": null, "name": "age", "option_fhir_rules": null, "optional": false, "options": [ { "label": "30-44", "value": 0 }, { "label": "45-54", "value": 1 }, { "label": "55-64", "value": 2 }, { "label": "65-74", "value": 3 }, { "label": "≥75", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "Mean intraocular pressure, mmHg", "mdcalc_info_concept": null, "name": "iop", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<22", "value": 0 }, { "label": "22 to <24", "value": 1 }, { "label": "24 to <26", "value": 2 }, { "label": "26 to <28", "value": 3 }, { "label": "≥28", "value": 4 } ], "show_points": true, "tips_en": "Mean of three measurements per eye", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "Mean central corneal thickness, µm", "mdcalc_info_concept": null, "name": "cct", "option_fhir_rules": null, "optional": false, "options": [ { "label": ">600", "value": 0 }, { "label": "576–600", "value": 1 }, { "label": "551–575", "value": 2 }, { "label": "526–550", "value": 3 }, { "label": "≤525", "value": 4 } ], "show_points": true, "tips_en": "Mean of three measurements per eye", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "Mean vertical cup-to-disc ratio by contour", "mdcalc_info_concept": null, "name": "cdr", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<0.3", "value": 0 }, { "label": "0.3 to <0.4", "value": 1 }, { "label": "0.4 to <0.5", "value": 2 }, { "label": "0.5 to <0.6", "value": 3 }, { "label": "≥0.6", "value": 4 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "Mean pattern standard deviation, dB", "mdcalc_info_concept": null, "name": "stdev", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<1.8", "value": 0 }, { "label": "1.8 to <2.0", "value": 1 }, { "label": "2.0 to <2.4", "value": 2 }, { "label": "2.4 to <2.8", "value": 3 }, { "label": "≥2.8", "value": 4 } ], "show_points": true, "tips_en": "2 measurements per eye of: Humphrey full threshold 30-2, SITA Standard 30-2 or 24-2, or loss of variance from Octopus 32-2", "type": "radio" } ]

instructions

published

2022-04-21T20:28:06.040Z

purpose

[ "Prognosis" ]

search_terms

[ "glaucoma", "open-angle glaucoma", "ocular hypertensive", "OHTS", "ocular hypertension treatment study" ]

seo

{ "keywords_en": "Glaucoma, open-angle glaucoma, ocular hypertensive, OHTS, Ocular hypertension treatment study, POAG", "meta_description_en": "The Ocular Hypertension Treatment Study (OHTS) Calculator identifies patients that may benefit from intraocular pressure (IOP) lowering therapy." }

specialty

[ "Ophthalmology" ]

departments

[ "HEENT", "Ophthalmic" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10496, "short_title_en": "mTOq-4", "slug": "migraine-treatment-optimization-questionnaire-mtoq-4" }, { "calcId": 10035, "short_title_en": "DIRE Score", "slug": "dire-score-opioid-treatment" }, { "calcId": 3825, "short_title_en": "BCLC Staging Classification", "slug": "barcelona-clinic-liver-cancer-bclc-staging-classification-treatment-guidelines" } ]

ismed

true

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "otolaryngology", "ophthalmology" ]

cleaned_use

[ "Use in an outpatient setting in patients 30-80 years old with ocular hypertension to assess need for initial treatment to reduce the likelihood of progression to glaucoma." ]

pub

false