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Invited Commentary
July 2017

Use of Structural End Points in Glaucoma: Beyond Visual Field Loss

Author Affiliations
  • 1USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles
JAMA Ophthalmol. 2017;135(7):789-790. doi:10.1001/jamaophthalmol.2017.1657

In 2009, the National Eye Institute (NEI) and the US Food and Drug Administration recommended using patient-reported outcomes (PROs) in clinical trials evaluating ophthalmic drugs and devices.1 For glaucoma, clinical practice traditionally does not use PROs but uses measures, such as intraocular pressure reduction and visual field (VF) loss, to monitor the effect of intervention and disease progression. However, there is an increasing recognition that PROs are valuable tools for assessing the way a disease or treatment affects a patient’s functions—information that clinical measures, such as VF or intraocular pressure, may not capture. Instruments such as the 25-item NEI Visual Function Questionnaire (NEI VFQ-25) have been validated and proven useful as PROs in clinical trials of patients with glaucoma. In clinical practice, clinicians can use PROs to monitor changes or responses to treatment, prioritize health problems, facilitate patient-clinician communication, and identify patient treatment preferences.

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