[Early Manifest Glaucoma Trial update 2004].

Elevated intraocular pressure (IOP) represents one of the most important risk factors for developing glaucomatous optic neuropathy. The "Early Manifest Glaucoma Trial" (EMGT) was initiated to answer the question of how immediate IOD-lowering therapy affects the progression of early manifest glaucoma and which clinically relevant factors are important. The study compares 129 patients undergoing treatment with 126 patients receiving no IOP-lowering therapy. IOP remained virtually constant in the untreated group, while a reduction of 25% was achieved in the treatment group. The results of the EMGT indicate that glaucoma progression is influenced by higher initial IOP, pseudoexfoliation or bilateral glaucoma, poorer MD value, higher age, and marginal papillary hemorrhage. No clear conclusions can be drawn regarding the significance of cardiovascular risk factors.