https://pubmed.ncbi.nlm.nih.gov/38093486
A recent systematic review examined the quality and consistency of clinical practice guidelines for glaucoma suspects. The review, published in Clinical & Experimental Ophthalmology, included 20 guidelines and assessed their quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument.
The results showed that 80% of the guidelines had low scores (≤2 domains with scores >66%) in the AGREE II assessment, with the lowest scoring domains being applicability, editorial independence, and stakeholder involvement. There was poor agreement across guidelines on the definition of a “glaucoma suspect” or “primary open angle glaucoma (POAG) suspect,” as well as the recommendations and criteria for treatment initiation in these populations. However, there was better agreement for the definition and recommendations for treatment initiation for “primary angle closure suspects.”
The authors concluded that there is substantial room for improvement in the methodological quality of most current international clinical guidelines for glaucoma suspects. They noted that clinicians should consider this finding when using such guidelines to inform their care of glaucoma suspects. The substantial variation in the definition of a POAG suspect and recommendations for treatment initiation also highlights important gaps in the current evidence for accurate prediction of glaucoma development and treatment effectiveness in these individuals.
In summary, this systematic review found significant variations and methodological issues in the available clinical practice guidelines for glaucoma suspects. The findings highlight the need for improved guidelines and evidence-based approaches for identifying and managing glaucoma suspects.
