PURPOSE: To evaluate routine intraocular pressure (IOP) control in monotherapy patients in the United States and Germany. METHODS: Meta-analysis of published articles. We included articles that were prospective studies of ocular hypotensive therapies that measured an unaltered (visit 1) IOP on monotherapy before enrolling into a clinical trial. RESULTS: This meta-analysis included 5 studies with 7913 patients, of whom 3245 were from the United States (n=1) and 4668 were from Germany (n=4). In the United States, 2939 patients (91%), and in Germany, 4059 patients (87%), had glaucoma (p<0.0001). Of these, all the US patients (100%) and 2694 (58%) of those from Germany were treated with monotherapy. The mean IOP with individual monotherapies in the United States was 19.6+/-2.2 and in Germany 20.8+/-0.8 mmHg (p=0.015). Among individual classes of medicine, patients treated with a prostaglandin demonstrated equal pressures (18.8 mmHg, p=0.60) in both countries, whereas the United States showed a lower pressure (20.2 mmHg) than Germany (21.2 mmHg, p=0.0019) with beta blockers. US physicians less often indicated that IOP was adequately controlled (n=1035, 32%) than in Germany (n=2030 of all patients, 44%, p<0.0001). CONCLUSIONS: This study suggests that patients treated by individual monotherapies in the United States demonstrate a lower pressure, but generally are more often considered uncontrolled, than those in Germany. This finding, if true, indicates a possible variance in treatment goals, or access to treatment, between the United States and Germany in treating patients with elevated pressure.
PURPOSE: To evaluate routine intraocular pressure (IOP) control in monotherapy patients in the United States and Germany. METHODS: Meta-analysis of published articles. We included articles that were prospective studies of ocular hypotensive therapies that measured an unaltered (visit 1) IOP on monotherapy before enrolling into a clinical trial. RESULTS: This meta-analysis included 5 studies with 7913 patients, of whom 3245 were from the United States (n=1) and 4668 were from Germany (n=4). In the United States, 2939 patients (91%), and in Germany, 4059 patients (87%), had glaucoma (p<0.0001). Of these, all the US patients (100%) and 2694 (58%) of those from Germany were treated with monotherapy. The mean IOP with individual monotherapies in the United States was 19.6+/-2.2 and in Germany 20.8+/-0.8 mmHg (p=0.015). Among individual classes of medicine, patients treated with a prostaglandin demonstrated equal pressures (18.8 mmHg, p=0.60) in both countries, whereas the United States showed a lower pressure (20.2 mmHg) than Germany (21.2 mmHg, p=0.0019) with beta blockers. US physicians less often indicated that IOP was adequately controlled (n=1035, 32%) than in Germany (n=2030 of all patients, 44%, p<0.0001). CONCLUSIONS: This study suggests that patients treated by individual monotherapies in the United States demonstrate a lower pressure, but generally are more often considered uncontrolled, than those in Germany. This finding, if true, indicates a possible variance in treatment goals, or access to treatment, between the United States and Germany in treating patients with elevated pressure.