Ocular Hypertension and the Risk of Blindness

Purpose: To estimate the risk of blindness in patients with ocular hypertension (OHT) using an appropriate model and current empirical data.Design: A Markov model with data from a systematic literature review.Methods: A Markov model with 3 health states was built: OHT, primary open-angle glaucoma (POAG), and unilateral blindness. Literature was searched for reports on conversion from OHT to POAG and progression from POAG to blindness, to estimate a range of annual conversion and progression probabilities. The model had a cycle length of 1 year.Results: The 15-year risk estimates ranged from 3.1% to 9.4% in untreated, and from 0.9% to 8.6% in treated patients with OHT. The ranges were the result of differences in patient populations, treatments, and outcome definitions in currently available empirical data.Conclusions: The best estimates of the 15-year risk of unilateral blindness in patients with OHT, based on the currently available empirical data and an appropriate model, show that the risk is