Medeiros et al developed a model for predicting the risk of progression from ocular hypertension to glaucoma using the data from the Ocular Hypertension Treatment Study (OHTS). The authors are from the Hamilton Glaucoma Center ad the University of California in San Diego.
Parameters:
(1) age
(2) diabetes mellitus
(3) intraocular pressure in mm Hg
(4) central corneal thickness (CCT) in microns (micrometers, µm)
(5) vertical cup to disc ratio
(6) pattern standard deviation (PSD)
Parameter |
Finding |
Points |
---|---|---|
age in years |
40 to 44 |
0 |
|
45 to 49 |
1 |
|
50 to 54 |
2 |
|
55 to 59 |
3 |
|
60 to 64 |
4 |
|
65 to 69 |
5 |
|
70 to 74 |
6 |
|
75 to 80 |
7 |
diabetes mellitus |
no |
0 |
|
yes |
-9 |
intraocular pressure |
23 mm Hg |
0 |
|
24 |
1 |
|
25 |
2 |
|
26 |
3 |
|
27 |
4 |
|
28 |
5 |
|
29 |
6 |
|
30 to 31 |
7 |
|
32 |
8 |
central corneal thickness |
670 to 689 microns |
0 |
|
650 to 669 |
3 |
|
630 to 649 |
5 |
|
610 to 629 |
8 |
|
590 to 609 |
11 |
|
570 to 589 |
13 |
|
550 to 569 |
16 |
|
530 to 549 |
19 |
|
510 to 529 |
21 |
|
490 to 509 |
24 |
|
470 to 489 |
27 |
|
450 to 459 |
30 |
vertical cup to disc ratio |
0.1 |
0 |
|
0.2 |
2 |
|
0.3 |
5 |
|
0.4 |
7 |
|
0.5 |
10 |
|
0.6 |
12 |
|
0.7 |
15 |
|
0.8 |
17 |
|
0.9 |
20 |
pattern standard deviation |
1.00 to 1.19 |
0 |
|
1.20 to 1.39 |
2 |
|
1.40 to 1.59 |
4 |
|
1.60 to 1.79 |
6 |
|
1.80 to 1.99 |
8 |
|
2.00 to 2.19 |
10 |
|
2.20 to 2.39 |
12 |
|
2.40 to 2.59 |
14 |
where:
• The table is based on the full equations with logarithms as given on page 1353.
• The negative points for diabetes reflects the reduced risk for glaucoma progression.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: -9
• maximum score: 79
• The higher the score the greater the risk for progression to glaucoma within 5 years.
Total Score |
Percent of Patients Showing Glaucoma at 5 Years |
-9 to 12 |
< 1% |
13 - 27 |
1 - 5% |
28 - 33 |
6 - 10% |
34 - 37 |
11 - 15% |
38 - 40 |
16 - 20% |
41 - 44 |
21 - 30% |
45 - 47 |
31 - 40% |
48 - 50 |
41 - 50% |
51 - 79 |
> 50% |
Purpose: To predict the risk of progression from ocular hypertension to glaucoma using the model of Medeiros et al.
Specialty: Ophthalmology
Objective: risk factors, severity, prognosis, stage, disease progression
ICD-10: H40,