The laser in glaucoma and ocular hypertension (LiGHT) trial. A multicentre randomised controlled trial: baseline patient characteristics
journal contribution
posted on 2023-07-26, 14:12authored byEvgenia Konstantakopoulou, Gus Gazzard, Victoria Vickerstaff, Yuzhen Jiang, Neil Nathwani, Rachael Hunter, Gareth Ambler, Catey Bunce
Purpose: The laser in glaucoma and ocular hypertension
(LiGHT) trial aims to establish whether initial treatment
with selective laser trabeculoplasty (SLT) is superior to
initial treatment with topical medication for primary open
angle glaucoma (POAG) or ocular hypertension (OHT).
Design LiGHT is a prospective unmasked, multicentre,
pragmatic, randomised controlled trial (RCT).
Participants 718 previously untreated patients with
POAG or OHT were recruited at 6 UK centres between
2012 and 2014.
Methods: Patients were randomised to initial SLT
followed by medical therapy or medical therapy
without laser. Participants will be monitored for 3
years, according to routine clinical practice. The primary
outcome is EQ-5D-5L. Secondary outcomes are treatment
pathway cost and cost-effectiveness, Glaucoma Utility
Index (GUI), Glaucoma Symptom Scale, Glaucoma Quality
of Life (GQL), pathway effectiveness, visual function,
safety and concordance.
Results: A total of 555 patients had POAG and 163
OHT; 518 patients had both eyes eligible. The mean age
for patients with POAG was 64 years and for OHT 58
years. 70% of all participants were white. Median IOP
for OHT eyes was 26mm Hg and 23mm Hg for POAG
eyes. Median baseline visual field mean deviation was
−0.81 dB for OHT eyes and −2.82 dB for POAG eyes.
There was no difference between patients with POAG
and patients with OHT on the EQ-5D-5DL; the difference
between OHT and POAG on the GUI was −0.02 and
1.23 on the GQL.
Conclusions: The LiGHT trial is the first RCT to compare
the two treatment options in a real-world setting. The
baseline characteristics of the LiGHT cohort compare well
with other landmark glaucoma studies.