title: Best practice treatment algorithm for primary open-angle glaucoma: implications for U.S. ophthalmology practice.
abstract: The objective of this study was to develop a "best-practice" treatment algorithm for the management of primary open-angle glaucoma in patients receiving initial medical therapy, to serve as a consideration for future ophthalmology practice. For comparison, a baseline, "common-practice" treatment algorithm was also created that reflects current ophthalmology practice patterns. Survey instruments were developed based on a comprehensive review of relevant literature, along with input from a general ophthalmologist. A panel of eight ophthalmologists subspecialized in glaucoma management was surveyed. Consensus was achieved using a modified Delphi technique. A comparison of common- and best-practice treatment algorithms suggests that in contrast with expert opinion, nonselective beta blockers are currently used more often, and alpha-2 agonists less often, as first-line therapy for the treatment of primary open-angle glaucoma.
authors.affiliation: Mount Sinai School of Medicine, New York City, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Serle
authors.forename: Louis
authors.initials: L
authors.lastname: Cantor
authors.forename: Ron
authors.initials: R
authors.lastname: Gross
authors.forename: Jay
authors.initials: J
authors.lastname: Katz
authors.forename: Thomas
authors.initials: T
authors.lastname: Mundorf
authors.forename: Robert
authors.initials: R
authors.lastname: Noecker
authors.forename: Todd
authors.initials: T
authors.lastname: Severin
authors.forename: Steve
authors.initials: S
authors.lastname: Simmons
authors.forename: John
authors.initials: J
authors.lastname: Walt
authors.forename: Julian
authors.initials: J
authors.lastname: Casciano
authors.forename: Stacy
authors.initials: S
authors.lastname: Evans
authors.forename: John
authors.initials: J
authors.lastname: Doyle
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000465:Algorithms; D019985:Benchmarking; D003657:Decision Making; D003697:Delphi Technique; D019468:Disease Management; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D019538:Health Care Surveys; D006801:Humans; D009885:Ophthalmology / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012985:Software Design; D014481:United States
chemical_list: D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists