Systematic review of clinical practice guidelines for the diagnosis and management of open angle glaucoma

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Methods : A systematic review of CPGs for the diagnosis and management of OAG, published between January-2017 and November-2024, was carried out with a search in databases, meta-search engines, CPG development institutions, ophthalmology associations and CPG repositories(PROSPERO:CRD42024510656). 5 authors evaluated them independently, using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. An individual assessment by domain (AGREE-II), an overall assessment of the guide, and its use with or without modifications was performed. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes was carried out. Results : The lowest mean scores were in applicability and rigour of development(mean 43.2% and 46.1% respectively). The highest score(mean 73.9%) was for domain 4-‘Clarity of presentation’. NICE(92.1%), IETSI(77.5%) and SNSG(75.8%) presented the best score in domain 3-‘Rigour of development’. Only NICE, EGS-5-TGG, SNS, and MaHTAS are recommended, the last two with modifications when evaluating the overall quality of the analyzed CPGs. Most of the CPGs used GRADE approach for making recommendations. In the meta-synthesis, the CPGs show similar recommendations, however, we found variability in indications for selective laser trabeculoplasty(SLT) and minimally invasive glaucoma surgery(MIGS). Conclusions : NICE, IETSI and SNSG CPGs for the diagnosis and management of OAG have a high methodological quality, appraised with AGREE-II. NICE, EGS-5-TGG, IETSI and SNSG have high scores in applicability. Health sciences/Medical research/Epidemiology Health sciences/Medical research/Outcomes research Health sciences/Diseases/Eye diseases/Ocular hypertension/Glaucoma Figures Figure 1 INTRODUCTION Open angle glaucoma(OAG) is a “chronic, progressive, potentially blinding, irreversible eye disease causing optic nerve rim and retinal nerve fiber layer loss with related visual field defects”; characterized by a normal angle, associated with several risk factors( 1 ), with a prevalence in Europe of 2.60%( 2 ). A timely diagnosis and treatment are relevant to avoid a progression leading to irreversible blindness as it enlightens in several clinical practice guidelines. Clinical practice guidelines (CPG) are “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances”( 3 ). CPG for the diagnosis and management of glaucoma have evolved through the years, with different editions developed by organizations like American-Academy-of-Ophthalmology(Preferred-Practice-Pattern-2016( 4 ) and 2020( 5 )), European-Glaucoma-Society (Terminology and Guidelines 4th ( 6 ) and 5th edition( 1 )) and Asia-Pacific-Glaucoma Society (3rd ( 6 ) and 4th ( 7 ) edition). The most applied method to assess CPG methodological quality is the “Appraisal of Guidelines for Research & Evaluation”(AGREE) Instrument( 8 ). Several studies have assessed the quality of CPG in primary open angle glaucoma(POAG)( 9 – 11 ), minimally invasive glaucoma surgery(MIGS)( 12 , 13 ) and childhood glaucoma( 14 ). The aim of this paper was to assess the methodological quality of CPG for the diagnosis and management of OAG. MATERIAL AND METHODS A systematic review of CPGs was conducted in compliance with methodology reports( 15 – 17 ), as well as previous studies carried out by our team( 13 , 18 ). Protocol was registered in the International Prospective Register of Systematic Reviews(PROSPERO:CRD42024510656). Systematic literature search Two authors(JGO and ISO) conducted a systematic literature search for OAG CPGs in November 2023, with no limitations by language or year of publication. A search update was run in November 2024(eTable 1 and eTable 2). CPG screening Two authors(JGO and ISO) independently screened the titles and abstracts of identified records. Disagreements were resolved through discussion and reviewed by a third author(TGO). Guideline selection and data extraction CPGs were selected if they were written in English or Spanish, published within the last 7 years, and full text was available. CPG details were extracted and were not excluded on the basis of on overall quality. In the case of updated CPG, previous CPG(1 or 2 previous editions), supplements and additional files were searched, and data extracted. Guideline quality critical appraisal Five authors(JGO, SBU, RBE, RMB, CBM) critically appraised the quality of the guidelines using the AGREE II instrument( 8 , 19 ). Guideline clinical recommendation meta-synthesis: A meta-synthesis of most clinically relevant recommendations was performed. Two authors with experience in glaucoma(SBU and RMB) extracted independently the key recommendations and built a recommendations matrix, reviewed by a third author(CBM). Selected recommendations items were reviewed additionally by a senior author with experience in glaucoma(TGO). RESULTS Guideline selection Literature search through databases and meta-search engines retrieved 2944 records, from those, 1 955 were deleted using the duplicate detection tool of Rayyan web application. 989 records were screened by title and abstract using Rayyan web application, and 13 records were selected for full text review. Six articles were excluded because of the following reasons: wrong topic(n = 4) and old version of included guidelines(n = 2). 42 records were retrieved through GPGs developers or Ophthalmology organizations webpages. One CPG was retrieved from the “GuíaSalud del Sistema Nacional de Salud de España”(SNSG) and other from “Instituto de Evaluación de Tecnologías en Salud e Investigación–EsSalud, Perú”(IETSI) webpage. Two CPG were retrieved from “Guideline Central”. Other CPGs were excluded because of the following reasons: language not English/Spanish(n = 1), wrong topic(n = 32) and already included(n = 5). Manual search identified no additional study (eFig. 1). Finally, eleven CPG were selected, developed by: the American-Optometric-Association(AOA) Evidence-based Optometry-Guideline-Development Group( 20 ), the Asian-Pacific-Glaucoma-Society( 7 ), the Finnish-Association-of-Ophthalmologists and the Finnish-Glaucoma-Society( 21 ) published in English in January-2024 and in Finnish in March-2023( 22 ), Swedish-Ophthalmological-Society( 23 ) published in English in January-2024 and in Swedish in September-2022( 24 ), Japanese-Glaucoma-Society( 25 ) published in English in February-2023 and in Japanese in February-2022( 26 ), National-Institute-for-Health-and-Care-Excellence(NICE)( 27 ) first version published in 2017 with an update published in 2022, European-Glaucoma-Society( 1 ), Instituto-de-Evaluación-de-Tecnologías-en-Salud-e Investigación-EsSalud(IETSI)( 28 ), American-Academy-of-Ophthalmology( 5 ), Ministerio-de-Sanidad,Servicios-Sociales-e-Igualdad-de-España and Agència-de-Qualitat-i-Avaluació Sanitàries-de-Catalunya( 29 ), and Malaysian-Health-Technology-Assessment-Section-Medical-Development-Division-Ministry-of-Health-Malaysia( 30 )(Tables 1 and 2 ). Table 1 Selected CPG for the diagnosis and management of open angle glaucoma. Denomination Title Year of Publication Organization Language AOA ( 20 ) Care of the Patient with Primary Open-Angle Glaucoma 2024 American Optometric Association (AOA) Evidence-based Optometry Guideline Development Group English APGG ( 7 ) Asia Pacific Glaucoma Guideline 2024 Asian Pacific Glaucoma Society English FCCG ( 21 ) Finnish Current Care Guideline for diagnostics, treatment and follow-up of primary open-angle glaucoma, normal-tension glaucoma and pseudoexfoliative glaucoma 2024 ( 2023 ****) Finnish Medical Society Duodecim, the Finnish Association of Ophthalmologists and the Finnish Glaucoma Society - Finland English/Finnish NSG ( 23 ) Nordic and Swedish guidelines for the management of open-angle glaucoma 2024 ( 2022 ***) Swedish ophthalmological society – Sweden English/Swedish JGSG ( 25 ) The Japan Glaucoma Society guidelines for glaucoma − 5th edition 2023 ( 2022* *) Japan Glaucoma Society – Japan Japanese/English NICE ( 27 ) Glaucoma: diagnosis and management 2022 ( 2017 *) National Institute for Health and Care Excellence (NICE) – United Kingdom English EGS-5-TGG ( 1 ) Terminology and Guidelines for Glaucoma (5th edition) 2021 European Glaucoma Society-Europe English/Spanish IETSI ( 28 ) Guía de Práctica Clínica para el manejo de Glaucoma de Ángulo Abierto 2021 Instituto de Evaluación de Tecnologías en Salud e Investigación - EsSalud – Perú Spanish POAG-PPP-2020 ( 5 ) Primary Open-Angle Glaucoma Preferred Practice Pattern® 2020 American Academy of Ophthalmology – United States of America English SNSG ( 29 ) Guía de Práctica Clínica sobre Glaucoma de Ángulo Abierto 2017 Ministerio de Sanidad, Servicios Sociales e Igualdad de España and Agència de Qualitat i Avaluació Sanitàries de Catalunya - Spain Spanish MaHTAS ( 30 ) Management of Glaucoma 2017 Malaysian Health Technology Assessment Section Medical Development Division, Ministry of Health - Malaysia English **** Published in Finnish in March 2023 *** Published in Swedish in September 2022 **Published in Japanese in February 2022 * Last updated: 26 January 2022 AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Table 2 Characteristics of CPG for the diagnosis and management of open angle glaucoma. Characteristic Subcharacteristic AOA APGG a FCCG NSG JGSG NICE EGS-5-TGG IETSI POAG-PPP-2020 SNSG MaHTAS Guideline status New Update Update Update Update Update Update New Update New Update Developer organization Society Society Society and PO PO Society PO Society PO Society PO PO Funding Yes Yes Yes NR Yes NR NR Yes Yes Yes Yes Development group Number 28 44 10 8 25 9*(25**) 54 14 9 16 16 Affiliation details Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Specialty/sub-specialty details No No No No No Yes No Yes No Yes Yes Non-physician specialist Yes No NR NR No Yes NR Yes NR Yes Yes Population representative Yes No NR**** No No Yes NR No NR Yes No Methodologist Yes No NR NR NR Yes Yes Yes Yes Yes Yes External review Yes Yes NR NR NR Yes Yes Yes Yes Yes Yes General features Objective Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Scope Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Target users Yes Yes No No No Yes Yes Yes Yes Yes Yes Population Yes Yes Yes No No Yes Yes Yes Yes Yes Yes Evidence searches Search strategy Yes No No No No Yes No Yes Yes Yes Yes Number of referenced citations 508 707 173 3 302 170 117 27 243 147 123 Update Previous guide NA 2016 2014 2012 2017 2009 2014 NA 2015 NA 2008 Next update 2026–2029*** NR NR NR NR NR NR 2024*** 2025 NR 2021 Detailed declaration of conflict of interest Yes Yes Yes NR Yes Yes No Yes Yes Yes No Monitoring and/or auditing criteria Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Evidence and grading of recommendations NR NR GRADE NR GRADE± GRADE GRADE GRADE GRADE GRADE GRADE Clinical questions in the CPG 0 0 9 0 14 1***** 16 8 0 38 16 NR: Not reported NA: Not applicable. PO: Public Organization *2021 Guideline Update Committee **2017 Guideline Committee members and NGC technical team members ***Based on their update plan ****Not reported in the Guideline Development Group (GDG), but considered in during the development. *****1 question for the updated version. a: CPG with no free access. Available through Santen Pharmaceuticals, owner of the rights to distribute it. AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Guideline quality Regarding quality of evidence, most of the CPG used CPG used GRADE system for rating quality of evidence and grading recommendation(Table 2 ). Of the six domains from AGREE-II(Table 3 ), the lowest score was in domain 6-“Editorial independence”(EGS-5-TGG and NSG), and the highest score was in domain 4-“Clarity of Presentation”(NICE). NICE Guideline presented the best score in domain 3-“Rigour of development”(92.1%)(Tables 3 and 4 ). Table 3 Domain scores (%) Domain AOA APGG FCCG NSG JGSG NICE EGS-5-TGG IETSI POAG-PPP-2020 SNSG MaHTAS MEAN 1: Scope and Purpose 52.2% 32.2% 83.3% 31.1% 37.8% 92.2% 82.2% 72.2% 37.8% 96.7% 77.8% 63.2% 2: Stakeholder Involvement 66.7% 27.8% 41.1% 15.6% 18.9% 80.0% 66.7% 53.3% 43.3% 88.9% 64.4% 51.5% 3: Rigour of Development 63.8% 11.3% 41.3% 5.8% 25.8% 92.1% 30.4% 77.5% 39.2% 75.8% 44.2% 46.1% 4: Clarity of Presentation 91.1% 73.3% 60.0% 47.8% 65.6% 97.8% 88.9% 78.9% 42.2% 94.4% 73.3% 73.9% 5: Applicability 31.7% 12.5% 40.0% 29.2% 21.7% 80.0% 36.7% 56.7% 41.7% 61.7% 63.3% 43.2% 6: Editorial Independence 35.5% 45.0% 55.0% 0% 35.0% 90.0% 0% 58.3% 86.7% 80% 38.3% 47.6% Overall Guideline Assessment 3 3 3 2 3 6 4 3 3 5 4 3,5 Recommendation No No No No No Yes, w/o modif. Yes, w/ modif. No No Yes, w/ modif. Yes, w/ modif. - AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Table 4 Summary of Appraisers’ Comments on the Open Angle Glaucoma Clinical Practice Guidelines assessed, organized by AGREE II Domains AGREE II domain Strength Weaknesses 1. Scope and Purpose ● The objective is well defined (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG partially in JGSG, NSG, APGG, AOA). ● The health questions are covered (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG, partially in JGSG, AOA). ● Population to whom the guideline is meant to apply is described (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA partially in EGS-5-TGG, FCCG). ● Health questions are not specifically described (POAG-PPP-2020, JGSG, NSG, APGG). ● No description of excluded populations is available (IETSI, POAG-PPP-2020, JGSG, NSG, APGG). ● Population to whom the guideline is meant to apply is not described (JGSG, NSG, APGG). 2. Stakeholder Involvement ● Guideline development group included individuals from relevant professional groups: clinical and methodological (NICE, POAG-PPP-2020, SNSG, MaHTAS, JGSG, AOA, partially in NSG, FCCG). ● Views and preferences of the target population were addressed (NICE, SNSG, FCCG, AOA, partially in EGS-5-TGG). ● Target users were reported (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, APGG, AOA). ● Guideline development group partially describes the expertise, institution, geographical location, or member’s role (EGS-5-TGG, APGG, AOA). ● Does not include patient representatives (IETSI, NSG, JGSG, APGG). ● The views and preferences of the target population have not been sought (IETSI, POAG-PPP-2020, MaHTAS, NSG, JGSG, APGG). ● No description about discipline/content expertise, institution, or geographical location was reported (POAG-PPP-2020). ● No report of target users (FCCG, NSG) 3. Rigor of development ● Details of the strategy used were reported (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA, partially in NSG). ● The criteria for selecting the evidence are clearly described (NICE, IETSI, partially in POAG-PPP-2020, SNSG, MaHTAS, JGSG, FCCG, AOA). ● Strengths and limitations of the body of evidence are clearly described (NICE, IETSI, SNSG, MaHTAS, partially in JGSG, AOA). ● Methods for formulating the recommendations are described (IETSI, AOA, partially in SNSG, MaHTAS, JGSG and FCCG). ● The health benefits, side effects, and risks have been considered in formulating the recommendations (NICE, IETSI, SNSG, JGSG, AOA, partially in APGG). ● There is an explicit link between the recommendations and the supporting evidence (NICE, IETSI, SNSG, FCCG, AOA, partially in JGSG, APGG). ● The guideline has been externally reviewed by experts prior to its publication (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA). ● A procedure for updating the guideline was provided (IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA, partially in NICE). ● No details of the strategy used were reported (JGSG, APGG). ● Did not carry out systematic searches for costs, outcomes assessment by patients, feasibility, or implementation (IETSI, JGSG, APGG). ● The methods for formulating the recommendations are partially described (NICE, FCCG, APGG). ● Strengths and limitations of the body of evidence, methods for formulating recommendations, are not clearly described (POAG-PPP-2020, JGSG, FCCG, APGG). ● Health benefits, side effects, and risks in formulating recommendations, have not been reported (MaHTAS). ● There is no explicit link between the recommendations and the supporting evidence (MaHTAS, POAG-PPP-2020). ● A procedure for updating the guideline is not provided (EGS-5-TGG, JGSG, APGG). ● Guideline wasn’t externally reviewed (JGSG). ● Most of the domain items were not reported or free available (EGS-5-TGG, NSG). ● Guideline was externally reviewed, but external reviewers’ comments are not available (EGS-5-TGG, APGG). 4. Clarity of presentation ● Recommendations are specific and unambiguous (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA). ● The different options for management of the condition or health issue are clearly presented (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA). ● Key recommendations are easily identifiable (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, NSG, APGG, partially FCCG, AOA). ● Does not include several clinical issues relevant to glaucoma (IETSI). 5. Applicability ● Describes facilitators and barriers to its application (IETSI, MaHTAS, NICE, AOA, partially in SNSG, POAG-PPP-2020, NSG, APGG). ● Provides advice and/or tools on how the recommendations can be put into practice (NICE, IETSI. POAG-PPP-2020, SNSG, MaHTAS, FCCG, partially in AOA). ● Potential resource implications of applying the recommendations have been considered (NICE, EGS-5-TGG, POAG-PPP-2020, SNSG, FCCG, AOA). ● Presents clinical monitoring criteria (NICE, IETSI, MaHTAS, SNSG, partially reported (only clinical criteria) in EGS-5-TGG, POAG-PPP-2020, JGSG, NSG, FCCG, AOA). ● No description of how the information influenced the guideline development process and/or formation of the recommendations (NICE, JGSG, NSG, APGG). ● Does not describe facilitators and barriers to its application (EGS-5-TGG, JGSG, FCCG, APGG). ● Potential resource implications have not been considered (IETSI, MaHTAS, JGSG, NSG, APGG). ● No clinical monitoring criteria present (APGG) 6. Editorial independence ● Competing interests of guideline development group members have been recorded and addressed (NICE, IETSI, POAG-PPP-2020, SNSG, JGSG, FCCG, APGG, AOA). ● Guideline report details about funding body (MaHTAS, APGG, partially in AOA). ● No description about funding body or competing interests of guideline development group is available (EGS-5-TGG, NSG) ● There’s no statement that the views of the funding body have not influenced the content of the guideline (all guidelines). ● Competing interest of guideline development group are not described (MaHTAS, NSG). 7. Overall Guideline Assessment Recommended: ● No: AOA, APGG, FCCG, NSG, JGSG, IETSI, POAG-PPP-2020 ● Yes, with modifications: EGS-5-TGG, SNSG, MaHTAS ● Yes, without modifications: NICE *Comments specific to certain CPGs are indicated in parentheses; comments lacking denotations pertain to all eleven CPGs. AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Guideline clinical recommendation meta-synthesis: A meta-synthesis of most clinically relevant recommendations is presented in Table 5 . Selected recommendations included; general features(risk factors, screening, target intraocular pressure(IOP), corneal central thickness(CCT) correction, gonioscopy, standard automated perimetry(SAP), optical coherence tomography(OCT) for follow-up, management(laser trabeculoplasty as first line treatment, prostaglandin analogues(PGA) as first drug, other considerations, surgery/laser trabeculoplasty indication,), surgery(trabeculectomy, combined trabeculectomy with cataract surgery, MIGS, glaucoma drainage devices(GDD), non-penetrating deep sclerectomy(NPDS), lens extraction, cyclodestructive procedures and other issues(patient education and adherence, pregnancy and breastfeeding). Table 5 Recommendations Matrix of clinical practice guidelines for the diagnosis and management of OAG (Guideline clinical recommendation meta-synthesis). AOA (2024) APGG (2024) FCCG (2024) NSG (2024) JGSG (2023) NICE (2022) EGS-5-TGG (2021) IETSI (2021) POAG-PPP-2020 (2020) SNSG (2017) MaTHAS (2017) Risk factors /predictors Ocular Elevated IOP, myopia, corneal thickness, corneal hysteresis Higher IOP, thinner central cornea, myopia Age, IOP, pseudo exfoliation with Ocular Hypertension (OHT), optic nerve head hemorrhage, myopia Elevated IOP, exfoliation syndrome, moderate to high myopia, optic disc hemorrhages, pigment dispersion syndrome, thin CCT Elevated IOP, thin CCT, large C/D ratio, small optic nerve rim area, disc hemorrhage, large β-zone of peripapillary chorioretinal atrophy, low corneal hysteresis, low ocular perfusion pressure Level of IOP, CCT Elevated IOP, disc hemorrhage, myopia Elevated IOP, myopia Elevated IOP, thin CCT, myopia, low ocular perfusion pressure Elevated IOP, myopia Elevated and/or asymmetry of IOP, thinner CCT, myopia, corneal hysteresis Other Increasing age, genetics and positive family history, race/ethnicity, type 2 diabetes mellitus, hypertension/hypotension Older age, family history of glaucoma, race or ethnicity (Hispanics/Latinos, Africans and South Central Asians), low diastolic perfusion pressure (< 50 mmHg) Family history of glaucoma, African ancestry, reduced perfusion pressure Older age, family history, non-Caucasian ethnicity (mainly African), low diastolic blood pressure Age, family history of glaucoma, low diastolic and systolic blood pressure, type 2 diabetes, exfoliation syndrome, poor drug adherence Family history, life expectancy Older age, non-White ethnicity (particularly Black), family history of glaucoma, pseudo exfoliation, low diastolic blood pressure Older age, black and/or hispanic ethnicity, family history of glaucoma, diabetes Older age, family history of glaucoma, African race or Latino/Hispanic ethnicity, type 2 diabetes Age, ethnicity (predominantly black), diabetes, family history of glaucoma Older age; West African, Afro-Caribbean or Hispanic/Latino ethnicity; positive family history, Obstructive Sleep Apnea Syndrome, diabetes mellitus Screening The evidence is insufficient to assess the benefits and harms of glaucoma screening in asymptomatic adults. Screening in the general population has not been found to be cost-effective. In the general population is not recommended In certain populations with a high risk of glaucoma blindness and low screening costs, community-based screening can be cost-effective. Not Recommended NC NC NC Not Recommended NC Screening is more useful and cost-effective when it is targeted at populations at high risk of glaucoma It is suggested to perform glaucoma screening in patients with risk factors for developing the disease Should be considered for patients with risk factors, especially: age > 40 years, family history of glaucoma, diabetes mellitus Target IOP May change depending on the results of long-term monitoring Target IOP should be individualized and reviewed at every follow-up visit based on disease severity, rate of progression, and life expectancy. Adjusted at each follow-up Continuously evaluated and adjusted Set according to the stage of glaucoma Prefer ‘clinically acceptable control of IOP’ Updated at each monitoring Target IOP will be determined and adjusted individually for each patient based on the treating physician´s criteria and periodic reevaluation Individualized and adjusted further down or even up during the disease It is reasonable to aim for a 25 to 50% reduction in baseline IOP without treatment, depending on the level of PIO, stages, age, presence of risk factors, rate of progression Individualized and adjusted during the disease Central corneal thickness (CCT) correction Is indicated as part of the evaluation of the patient with suspected glaucoma or ocular hypertension No No No No No No NC No NC No Gonioscopy Yes. Anterior segment-optical coherence tomography should not serve as a replacement for gonioscopy Yes. OCT-A can more precisely evaluate iris trabecular contact (ITC) in 360° compared with gonioscopy. Cannot be replaced by automated imaging Yes Yes, static and dynamic If not available, use OCT or Van Herick. Yes Yes. Use UBM exceptionally Yes If impossible, choose Van Herick Yes, static and dynamic Standard Automated Perimetry (SAP) Is a fundamental test for detecting visual field loss and for monitoring the rate of visual field change over time A personalized testing strategy is advisable. This tailored approach ensures that each patient receives optimal care tailored to their specific condition Factors such as disease stage, patient’s age, and current progression status should guide the frequency of VF testing Use the same instrument and protocol for follow-up. 2–6 VF are needed to confirm progression. In advanced glaucoma monitor progression with central 10-degree VF 5–6 Visual Field (VF) during the first 2 years, except patients with newly discovered OHT. Adapt the stimulus intensity and size according to the stage of glaucoma. Minimum of 5 VF to determine progression. Newly diagnosed glaucoma: measure as frequently as possible during the first 2 years. Establish a baseline and severity of impairment at diagnosis 3 times per year during the first 2 years in newly diagnosed patients Yes Repeat the same strategy that showed a new glaucomatous defect to confirm VF damage progression. Minimum of 6 VF in the first 2 years of diagnosis to calculate rate and progression Change stimulus size and strategy in advanced disease OCT for diagnosis and follow-up Yes. Is useful for documenting the status and progression OCT is a complementary tool rather than a replacement for a comprehensive clinical evaluation. Do not diagnose or assess progression based on OCT alone. Examinations with different devices are not comparable. Repeated examinations may show false positive progression. Floor effect in advanced glaucoma complicates assessment. Suitable for early stages. Not recommended in advanced glaucoma (floor effect) Useful for baseline documentation Don't diagnose solely on OCT Yes Yes Yes Yes Management Laser trabeculoplasty as first line treatment Yes Yes Yes Yes No: It is used as an alternative treatment for patients who cannot achieve target IOP using drug therapy Yes Yes No: If bad adherence to pharmacological treatment is expected Yes No: If bad pharmacological treatment adherence is expected. Don't associate with pharmacological treatment in patients with uncontrolled glaucoma. Yes Prostaglandin analogues (PGA) as first-line drug Yes Yes Yes. Yes Yes Yes Yes Yes Yes Yes Yes Other considerations Patients prescribed topical IOP lowering therapy may experience decreased tear film stability and elevated tear osmolarity and should be evaluated for ocular surface disease New medications and classes of drugs have been developed recently (selective EP2 receptor agonist and Rho kinase inhibitors), broadening our treatment options Beta blocker can be chosen as first line treatment. Fixed combination of PGA and beta blocker reduce IOP more than other combinations. For good adherence, a fixed combination is usually chosen Drug therapy is the first -line treatment for primary open-angle glaucoma. Do not offer treatment to people with suspected chronic open angle glaucoma (COAG) and IOP less than 24 mmHg unless they are at risk of visual impairment within their lifetime. Advise people to continue regular visits to their primary eye care professional. Fixed combination is preferable to multiple drugs Start treatment with two drugs in patients with high initial IOP Fixed combinations are not recommended for initial treatment In people with open-angle glaucoma, initial treatment with beta-blockers is recommended if prostaglandin analogues cannot be used Fixed combinations provide improved long-term adherence compared with non-fixed components Laser trabeculoplasty or Surgery indication NC Medical therapy failure in achieving optimal IOP control If insufficient response, intolerance to treatment or progression, despite lowered IOP If more than 3 drugs are required to achieve target IOP When multiple medications are required After treatment with medicines from 2 therapeutic classes When insufficiently controlled with two or three agents NC NC Consider if there is no response to medical treatment, or if there is progression If more than two medications are required to achieve target IOP Surgery Trabeculectomy Is therefore a long-term management option for IOP control The procedure is conventionally considered the gold standard of penetrating surgery to create a subconjunctival bleb without the need of an implant, resulting in a cost-effective approach to the surgical treatment of glaucoma. Is the most performed glaucoma filtering surgery. Complication’s area more frequent than in non-penetrating surgeries Gold standard Initial treatment for patients with inadequate control of IOP by drug therapy or laser therapy or for severe cases Offer people with advanced chronic open angle glaucoma (COAG), glaucoma surgery with pharmacological augmentation (Mitomycin C - MMC) as indicated When other forms of therapy have failed to control the disease or are not suitable; and target pressure is unlikely to be achievable with topical medications and/or laser. Adults with primary open angle glaucoma (POAG) that do not meet target IOP despite maximum tolerated pharmacological/laser treatment, are not suitable for pharmacological/laser treatment, or present advanced glaucoma damage at diagnosis. Indicated when medications and appropriate laser therapy are insufficient to control disease; can be considered as initial therapy in selected cases. In severe glaucoma and in cases with a high risk of progression despite optimal medical treatment Primary surgery of choice in primary open angle glaucoma (POAG) Combined trabeculectomy with cataract surgery NC NC NC Better IOP lowering than cataract surgery alone, but lower success rate than filtering surgery alone Weakly recommended NC IOP reduction is more than phacoemulsification alone. Success rate is less than filtration surgery alone NC Not as effective as glaucoma surgery alone in lowering IOP NC Significantly lower mean IOP than phacoemulsification alone MIGS General information about characteristics. Mention Trabectome surgery used in combination with cataract surgery Offer indications for use, recommendations enhance the success of implantation and recommendations postoperative management for trabecular meshwork MIGS (stents and procedures). Brief comment about MIGS. No evidence of the efficacy compared to traditional glaucoma surgery General information about characteristics, classification, and indications. Suitable in early or moderate glaucoma. Not sufficient information on long-term effects and safety Procedure should be performed by a surgeon with sufficient experience in anterior chamber angle surgery. Mentions: EX-PRESS, ab interno trabeculotomy (with metal hook, nylon thread or, trabectome) and iStent. NC A list of available techniques. Mild to moderate glaucoma. It is possible to combine it with phacoemulsification. Doesn't precise specific techniques. NC Description list of techniques. Some are only FDA approved to be performed concurrently with phacoemulsification. Less effective in lowering IOP than trabeculectomy and GDD. More favorable safety profile in the short term. Mentions: Trabectome, KDB, GATT with iTrack or suture, ABiC, iStent and iStent inject, Hydrus microstent, Xen gel stent. Lack of descriptions and recommendations Not recommended Non-penetrating deep sclerectomy (NPDS) NC Non-penetrating glaucoma surgery (NPGS) reduces IOP less effectively than penetrating surgery, but with lower complication rates. NPGS may reduce the hypotony risks of trabeculectomy in higher- risk patients, e.g., high myopes, younger patients, previous vitrectomy, eye-rubbers. Surgeon preference based on training and experience determines the preferred procedure (NPGS versus trabeculectomy) for the particular patient Brief comment NC Brief comment NC Brief comment NC Description of technique and brief comment about Deep sclerectomy Description of technique and offers recommendations (1 general and 4 specific) Brief comment Glaucoma drainage devices (GDD) Baerveldt GDDs resulted in greater IOP reduction but more early and serious complications than was encountered with patients receiving Ahmed valves Indications: previous failed trabeculectomy with antimetabolites, insufficient conjunctiva due to scarring, complicated and refractory glaucomas. Non-valved drainage devices result in greater postoperative hypotony than valved devices Higher success rate than trabeculectomy in eyes with previous intraocular surgery First-line surgical procedure in some cases Patients with unsuccessful trabeculectomy with concomitant use of antimetabolites, severe conjunctival scarring because of previous surgery, those who are unlikely to achieve successful trabeculectomy or technically cannot undergo other filtration procedures. Less effective in lowering IOP than trabeculectomy NC Patients with risk factors for a poor result of trabeculectomy with antifibrotics. Potential role as a primary surgical procedure in selected cases. Patients who do not meet target IOP or evidence a progression in visual field damage despite maximum tolerated pharmacological treatment and trabeculectomy, or when trabeculectomy has a high failure rate. Indicated when trabeculectomy has failed to control IOP or is deemed unlikely to succeed. Use patch allografts of sclera, cornea, or pericardium to prevent tube erosion. Patients that have not controlled IOP despite pharmacological treatment, or when filtering surgery has failed. GDDs are not the first choice of surgical treatment in naïve patients. Patients with high risk of failure from augmented trabeculectomy Lens extraction For patients with POAG results in a modest IOP decrease (13%), reduced medication requirement (12%). Some patients (up to 26%), however, experience worse IOP control and may require additional medications, laser surgery or both There is insufficient evidence to support that IOP reduction from cataract surgery can protect against VF deterioration. Might impair the filtration of a previous glaucoma surgery. The risk is lower if there is a time gap of over 12 months between surgeries. Consider early cataract surgery in patients with glaucoma. NC NC Cataract surgery alone as an intervention to control glaucoma is not recommended. Performed after trabeculectomy can affect the IOP control. NC Multifocal intraocular lenses may have adverse effects on contrast sensitivity and visual field performance in patients with glaucoma. NC The risk of bleb failure is reduced if lens extraction is performed > 6 months post-trabeculectomy. Cyclodestructive procedures Patients treated with endocyclophotocoagulation via the pars plana had lower IOPs, needed fewer glaucoma medications, and had a higher success than patients similarly treated via the limbus Both forms of diode lasers ( micropulse and standard) are effective forms of trans-scleral cyclophotocoagulation of ciliary body ablation. MicroPulse is thought to be safer, but less efficacious in terms of IOP lowering compared with standard cyclodiode. The technique chosen is based on surgeon preference and equipment availability Effective and safe in difficult-to-treat glaucoma. Repeated treatments are often required. When filtering surgery has not worked/is not effective enough or not feasible and in painful blind eyes Refractory cases in which other treatments are ineffective because it can cause vision threatening complications Offer cyclodiode laser treatment to people with chronic open angle glaucoma (COAG) (including advanced COAG) who prefer not to have glaucoma surgery or whom glaucoma surgery is not suitable Indicated when filtration surgery or GDD are likely to fail/have failed/are not feasible; and in refractory glaucoma Adults with primary open angle glaucoma (POAG) that don't meet target IOP despite treatment, patients that cannot have glaucoma drainage devices (GDD) implanted, and in painful blind eye Eyes with limited visual potential or that are otherwise poor candidates for incisional ocular surgery NC Indicated in painful blind eyes or eyes with poor vision, failed multiple filtering surgeries. May be performed in sighted eyes when the benefits outweigh the risks for incisional surgery. Other issues Patient education and adherence Recommended. Eye doctors should be persistent in providing education and training to improve adherence/compliance with recommended therapy Recommended. Adherence can be improved by identifying the barriers and addressing them strategically It is unclear whether patient education improves compliance Recommended. Glaucoma schools create affinity and exchange of experience between patients Recommended Recommended Recommended NC Recommended. Peer-support groups or counseling are helpful to some patients. Recommended Recommended Pregnancy and breastfeeding Pharmacological treatment of POAG should be used with caution during pregnancy and lactation Present or possible, renders all interventions potentially hazardous Discuss with the doctor that is treating the pregnancy whether to star treatment or to monitor without treatment NC Drug therapy for glaucoma should be discontinued during pregnancy, childbirth, and lactation. Laser therapy or surgery should be considered if IOP control worsens upon discontinuation of the drug. There are no glaucoma medications for which safety has been established in pregnant women, fetuses, or nursing mothers. Specific consideration in terms of discussions about management and pharmacological treatment. Temporary treatment discontinuation can be considered. No IOP-lowering medications have been labeled for use during pregnancy and/or breastfeeding. Systemic absorption should be reduced by punctal occlusion and eyelid closure. During breastfeeding, PGAs, carbonic anhydrase inhibitors and beta-blockers may be acceptable. NC The American Academy of Pediatrics has approved the use of carbonic anhydrase inhibitors during lactation. Brimonidine can cause apnea in infants, toddlers, and children; therefore, is not recommended to be used in mothers who are breastfeeding. Vaginal delivery is not contraindicated and must only be evaluated in cases of severe or advanced glaucoma. The ideal for newborn child, who is breastfed, is that de mother can control herself without medical treatment because all drugs can pass through the milk Topical beta-blockers can be the first-line medications when considering medical treatment of glaucoma in pregnancy. NC: Not covered AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section DISCUSSION Methodological Quality Glaucoma CPG has evolved with high quality CPG, unlike other diseases like retinal vein occlusion( 18 , 31 ). Four CPG(AOA,NICE,IETSI and SNSG) reached the minimum suggested for a high-quality CPG(at least 3/6 domains > 60% including domain 3), and 2(EGS-5-TGG and MaHTAS) for moderate-quality CPG(≥ 3 domains score > 60%, except Domain 3). EGS-5-TGG is the most used CPG in Europe, with a high score in clarity of presentation(88.9%), however it had a low score for “Rigour of development”. Including a diverse representation of clinical, scientific, and methodological experts”( 32 ) leads to a well-developed CPG. APGG, EGS-5-TGG and MaHTAS had low scores for “Rigour of development” despite including methodological experts, because of the absence of reporting the development process or making it available online, as other CPGs have done. However, they received high scores for the “Clarity of Presentation” domain. IETSI had the support of methodological experts, achieving high methodological scores with an adequate reporting, but its clinical recommendations are lowly valid. In guideline development group(GDG), clinical experts should “contextualize evidence, extrapolate evidence from indirect sources and interpret low-quality evidence”( 33 ), strengthening the credibility of the CPG “by acknowledging that the final document is based on both an exhaustive evaluation of the published literature(“evidence”) and the wealth of experience possessed by expert members”( 34 ), an issue not achieved by IETSI-CPG. A CPG ought to provide “a clear explanation of how the experts were chosen, how they reached a consensus, and which issues the experts were tasked with addressing”( 33 ). Ou et al.(2011)( 9 ) appraised 3 CPG using AGREE(first version): Preferred-Practice-Pattern ¿-in-Primary-Open-Angle-Glaucoma(2005), SEAGIG’s Asia-Pacific-Glaucoma-Guidelines(2003–2004), and EGS-Terminology-and-Guidelines-for-Glaucoma 2nd -edition(2003). They reported that on domain 3-“Rigour of development”, scores were close to 60%(American-Academy-of-Ophthalmology(AAO) 67%, EGS 63%, and SEAGIG 58%), with high scores in domain 4-“Clarity of presentation”(AAO 85%, EGS 79%, and SEAGIG 88%). The AGREE-I(first version), did not include “strengths and limitations of the body of evidence”(Item 9 in AGREE-II), an important issue in CPG development that could decrease the scores for domain 3. Several CPG assessed in our study failed to report the body of evidence properly, including Evidence-to-Decision frameworks( 35 ) or reporting GRADE tables(36), as NICE and IETSI did. Wu et al.(2015)( 10 ) evaluated the methodological quality of 3 CPG for OAG using AGREE II: American-Academy-of-Ophthalmology(AAO)-2010, Canadian-Ophthalmological-Society(COS)-2009, and National-Institute-for-Health-and-Care-Excellence(NICE)-2009. They reported that in domain 3-“Rigour of development”, scores were different(AAO 63%, COS 72% and NICE 92%). Also, clarity of presentation scored high (AAO 78%, COS 96%, NICE 97%), with NICE having the best scores over the other CPG evaluated, but all “failed to describe specific roles of panel members and/or delineate the involvement of patient representatives”, and “external review processes were unclear”. The description of roles of GDG and including patient representatives is important, considering that glaucoma is a chronic disease with several patient’s organizations. To improve CPG, GDG should include patients or patient representatives in CPG development; and “ensure that patients, patient organizations, and interested members of the public have an opportunity to review the CPG and describe how their comments were addressed”( 32 ). Only 4 CPG assessed in our study(AOA, FCCG, NICE and SNSG) considered patient representatives or included the views and preferences of the target population. Most CPG include patients in two steps “identifying the question” and “reviewing the draft guideline”, usually using a single method (e.g., group or individual contributions, surveys or Delphi)( 37 ). Urrego and Ñustes (2019)( 11 ) assessed 4 CPG for OAG in Colombia(Sociedad-Colombiana-de-Oftalmología 2010), México (Centro-Nacional-de-Excelencia-Tecnológica en Salud 2016), Chile-(Ministerio-de-Salud-2013) and Spain(SNSG). They reported that 2 CPG scored high in domain 3-“Rigour of Development”(Mexico 83.3% and SNSG 85.4%) and all CPG scored high in domain 4-“Clarity of presentation”(mean 90.27%). SNSG scored high scores in our assessment(scores > 60% in all domains), with the lowest score in Applicability and Rigour of the development, because of its publication date and search details. An update of the SNSG-CPG is available( https://portal.guiasalud.es/egpc/glaucoma-presentacion/ ) and introduce a note for readers:“More than 5 years have passed since the publication and its update is pending. The recommendations it contains must be considered with caution considering that their validity is pending evaluation”. CPGs become outdated after 3 years( 38 ), considering that their search strategy was updated before the publication of the CPG(using Re-run search or database alerts( 39 )). Most of the CPG assessed in our study did not perform the last process. Not include a pre-publication update or an evidence gap(time difference between search and publication dates) is frequent in CPG for OAG or MIGS procedures( 13 ). Wu et al.( 40 ) appraised the quality of clinical practice guidelines for glaucoma suspects, and its definition, including CPG like EGS-5-TGG, NICE, and MaHTAS. They reported that NICE and MaHTAS scored high in domain 3-“Rigour of development”(NICE 91%, MaHTAS 84%, and EGS-5-TGG 50%); and they scored high in domain 4-“Clarity of presentation”(NICE 92%, MaHTAS 89%, and EGS-5-TGG 89%). EGS-5-TGG was the only with 0% in “Editorial Independence”, similar to our scores for EGS-5-TGG and NSG. It is crucial to consider the importance of reporting Conflict-of-Interest(COI) in CPG since they are often not disclosed( 41 ), or inadequately divulged(payments not reported) ( 42 ). In critical appraisal, a complete assessment should be done( 43 ), especially when assessing CPG, where available tools for report of quality(RIGHT checklist, iCAHE Guideline Quality Checklist), adherence to Trustworthy Standards(NEATS), or development of quality(AGREE-II), recommends the reporting of COI( 44 ). Our scores are similar to what reported Wu et al. for these guidelines, however, Wu et al. scored higher for MaHTAS and EGS-5-TGG, assessed by 2 authors. In our study, 5 appraisers(3 ophthalmologist and 2 ophthalmologists with experience in glaucoma) appraised all the CPG, and 5 authors had previous experience in CPG appraisal( 18 , 45 – 47 ). Agree-II recommends at least 2 appraisers and preferably 4, because a higher number of appraisers increase the reliability( 8 , 19 ). High quality CPG may not necessarily have recommendations highly valid, implementable or clinical applicable, so a CPG should be evaluated for its methodology, content, and the use of its recommendations in clinical practice( 48 ). For the most comprehensive evaluation of ophthalmology CPGs, it is ideal to have ophthalmologists with expertise in evidence-based medicine, critical appraisal and guideline methodology, as they can appraise both the methodological process and the relevance of the content. EGS-5-TGG had a low score in domain 3, however they included easy-to-apply flowcharts, checklists, algorithms and summaries, becoming one of the most useful CPG for its use in daily clinical practice(recommended with modifications). IETSI CPG had a high score in domain 3 but with recommendations were lowly valid for ophthalmologists. Qureshi et al.(2021)( 49 ) identified systematic reviews(SR) of interventions for glaucoma and assessed their reliability. They reported that only 49/129-SR are reliable, and most reviews addressed OAG and OHT. Only 17-SR, were reliable for medical interventions and 16-SR for surgical and postoperative interventions; however, there was an uncertainty about the effectiveness of combined cataract surgery. Only 11-SR were reliable for laser and perioperative interventions, concluding that SLT is effective as the first line for POAG and selective ALT have similar efficacy to reduce IOP. Regarding surgical devices 5-SR were reliable, however there was uncertainty about MIGS effectiveness, and its use in combined surgery with cataract or MIGS alone. This SR included studies until August-2019, so it did not include results from LIGHT(Laser-in-Glaucoma-and-Ocular-Hypertension) or SALT(Steroids-After-Laser-Trabeculoplasty) trials. In the last years, the total number of recommendations in PPP has decreased, especially in glaucoma, however, high level of evidence recommendations has increased( 50 ). When making recommendations, GDG should include the impact on equity of recommendations, and promote equitable practices in older people, with limited economic resources, living in rural contexts, with poor access to health services, from racial and ethnic minorities, or in cases of cognitive or physical disability. Only NICE, IETSI and POAG-PPP-2020 addressed these issues. Guideline clinical recommendation meta-synthesis Several studies have reported several risk factors associated with glaucoma; however, recent evidence has reported obstructive sleep apnea as a risk factor(Odds Ratio 3.66)( 51 ). Other factors like smoking(moderate to heavy smoking) have shown conflicting evidence, showing an association with glaucoma progression(vessel density loss) ( 52 , 53 ) versus no association( 54 ), or alcohol(implicated in OAG risk, however mediating or confounding factors can be present)( 55 ). Rovelt et al. reported that several factors like Obstructive Sleep Apnea and Diabetes, are the risk factors assessed across different study designs, unlike other risk factors( 56 ). Most of the CPG do not recommend or addresses screening; however, APPG, PPP, SNSG and MATHAS recommend the screening in patients at high risk. The-United-States-Preventives Services-Task-Force(USPSTF), The United-Kingdom’s National-Screening-Committee, the Pan-American-Association-of-Ophthalmology, and The International-Council-of-Ophthalmology’s 2015 Glaucoma-Eye-Care-Task-Force neither recommend screening( 57 ). An evidence report published in 2022 by the USPSTF regarding Screening for Glaucoma in Adults reported limited direct evidence on glaucoma screening, showing no association with benefits( 58 ). Actually, there is controversy regarding the role of lens extraction(early cataract surgery recommended by NSG or not recommended as a surgery alone by EGS-5-TGG). Armstrong et al. reported that in patients with POAG, cataract surgery alone decreased IOP and the number of antiglaucoma medication(NAM) ( 59 ). IOP reduction was 11.9%, 14.4% and 15.4%, for 1 month, 1 and 2 years postoperatively, respectively( 59 ). A systematic review of randomized controlled trials reported that cataract surgery in patients with OAG had a decrease on IOP following surgery and a reduced dependency on glaucoma medications( 60 ). Pasquali et al. reported a significant IOP reduction in patients with OAG after cataract surgery(6, 12 and 24 months)( 61 ). Benekos et al reported that cataract surgery leads to a reduction of 3.77 mm-Hg (95%-CI:−5.55 to − 1.99) at 12 months( 62 ). The CPG evaluated the effectiveness of combined cataract and glaucoma surgery, and found that combined surgery with trabeculectomy may lead to a greater decrease in IOP but a lower success rate. A Cochrane review assessed the relative effectiveness and safety of combined surgery versus cataract surgery, and reported that there is low-quality evidence that combined surgery has better IOP control compared with cataract surgery alone( 63 ). Also, there was uncertainty regarding the complications of the surgery, and the quality of the evidence was very low(several types of glaucoma surgery) and poor(reporting of the outcomes)( 63 ). Most of the CPG recommended SLT, except JGSG, IETSI an SNSG, however, the last was the only CPG published before the first report of LIGHT-trial results. LIGHT changed the paradigm of the primary treatment for glaucoma and positioned the SLT as the primary treatment in patients with OAG. Zhou et al. reported on a Meta-Analysis published in 2021, that several types of lasers trabeculoplasty are equally effective for decreasing IOP compared with medical therapy( 64 ). 180-degree-SLT was slightly more effective than ALT reducing NAM, however there was no significant difference between 180° and 360° SLT at six months( 64 ). Rolim-de-Moura et al. reported on a Cochrane systematic review published in 2022, that Laser trabeculoplasty is better than antiglaucoma medication(AM) in terms of progression of open-angle glaucoma(visual field loss) and may be like modern eye drops in controlling eye pressure at a lower cost, with no serious unwanted effects( 65 ). Gazzard et al. published in 2023 the 6-years results of LIGHT-trial, and reported that SLT provides long-term control in patients with OAG vs antiglaucoma medications(AM), with a reduced need for incisional glaucoma and cataract surgery( 66 ). SLT is an effective long-term option to treat OAG, equivalent to ALT based on level I evidence, according to an HTA performed by the AAO in January-2024( 67 ). SLT can be used either as primary treatment, as a replacement for AM, or as an additional intervention in patients with AM( 67 ). Zhu et al reported a greater IOP reduction at one month and at one year with 360°-SLT compared with 180°, however, there was not a significant difference at 2 years( 68 ). Chavez et al. reported a higher proportion of patients achieving ≥ 20% IOP reduction in medical treatment group(compared with SLT)( 69 ). However, SLT had similar IOP control, with similar rate of eyes at target IOP, quality of life, visual field, and reduced rates of glaucoma surgeries, antiglaucoma medications, and ocular adverse effects( 69 ). Regarding MIGS, Michaelov et al.(2018) ( 12 ) assessed the methodological quality of 14-CPGs and recommendations for MIGS procedures. They reported several CPG scored high for Rigour of development(POAG-PPP 2016 94.4%, EGS 2014 68%, NICE 2009 99.3%). Also, only 3/11 CPGs mentioned MIGS as an option for surgical management of glaucoma(the APGG-2016, the POAG-PPP-2016, and the EGS-2014). On a recently published scoping review performed by our team, we assessed recommendations addressing MIGS in 13 OAG-CPG or MIGS procedures CPG like the NICE-Interventional-Procedure-Guideline and the EGS-SI(European-Glaucoma-Society-A-guide-on-surgical-innovation-for-glaucoma). We found that the assessed CPGs have not adequately addressed MIGS recommendations in terms of updated evidence, available procedures, and recommendations( 13 ). APGG was published in May 2024, so it was not included in this assessment; however, they included a chapter describing available procedures and techniques( 7 ). Most of CPG recommend trabeculectomy as gold standard, however this statement could change in future years. Since introducing MIGS, trabeculectomy became less used or is indicated when MIGS fails. Zaifar et al. reported that when comparing cataract + MIGS vs cataract + trabeculectomy, both combined surgeries have similar outcomes, but the first has less severe complications (e.g. hypotony, maculopathy, and choroidal effusion)( 70 ). CPG recommends Glaucoma drainage devices(GDD) in eyes with risk factors for a poor result of trabeculectomy or in cases with previous intraocular surgery. The Primary-Tube-Versus-Trabeculectomy study was a multicenter randomized clinical trial comparing the safety and efficacy of tube shunt surgery and trabeculectomy with mitomycin-C(MMC) in eyes without previous ocular surgery. They reported similar IOP reduction for both procedures after 5 years, however; the NAM was lower for trabeculectomy( 71 ). A recently published Health-Technology-Assessment(HTA) from the AAO(February-2024) assessed the “efficacy and safety of the use of aqueous shunts with extraocular reservoir for the management of adult OAG”, and reported that valved/non-valved devices are effective at lower IOP in eyes with and without prior incisional surgery, supported by strong evidence( 72 ). Also, they reported that evidence to show superiority of tubes over trabeculectomy as a primary glaucoma surgery is lacking( 72 ). Few CPG addressed non-penetrating-deep-sclerectomy(NPDS). NPDS is a worldwide procedure that prevents the sudden hypotony related to penetrating surgery and lets the filtration of aqueous humour through trabeculo-Descemet membrane. NPDS reports showed a marginally lower effect over IOP compared with trabeculectomy, but same efficacy, and lower risks of complication( 73 ). One issue with NPDS is that a peak emerges some months after the surgery, requiring a goniopuncture to be performed. Slagle et al. reported that a “3 month cut-off was associated with better IOP control and less adverse events than early laser goniopuncture”( 74 ). NPDS can be performed alone or in combination with cataract surgery; with no devices or using a Nonabsorbable-Uveoscleral-Implant(Esnoper-Clip)( 75 ). When comparing NPDS alone or in combination with cataract surgery, efficacy is similar, and the last achieves excellent IOP control( 76 , 77 ). When comparing penetrating and NPDS, the last had a better safety profile(Best-Corrected-Visual-Acuity recovery, complication rates and post-operative interventions)( 78 ). Patients’ adherence to glaucoma medications is a relevant issue. Most of the CPG recommend patient education and adherence, which includes benefits in side effects of treatment, proper instillation technique of eye drop and compliance and continuity to treatment; however, FGCC reports an unclear effect of education over compliance. EGS assessed the interventions that can improve adherence to medical treatment, and reported that “simplified regime, education, effective communication, and alarms/messages” have very low level of evidence, with a weak strength of recommendation. CPG makes recommendations for future research, addressing epidemiological, clinical, diagnostic, or treatment issues. Only AOA, NICE, JGSG, IETSI, and SNSG guidelines suggest topics with insufficient evidence that researchers can address nearby as clinical questions for better decision-making. Azuara et al. reported EGS research priorities for glaucoma care and includes: stop sight loss/stopping progression of glaucoma, improved detection of worsening glaucoma/better tools to detect progression, better surgical or laser treatments including improved MIGS or better evidence for MIGS, and treatments with fewer side effects( 79 ). Finally, glaucoma is an ophthalmological condition, continuously evolving with recent developments, most of them with the goal of achieve relevant outcomes. Results do not show which CPG is better, but we can report that NICE, IETSI and SNSG CPGs for the diagnosis and management of OAG have a high methodological quality, appraised with AGREE-II. NICE, EGS-5-TGG, IETSI and SNSG have high scores in applicability. Finally, NICE, IETSI and SNSG CPGs for the diagnosis and management of OAG have a high methodological quality, appraised with AGREE-II. NICE, EGS-5-TGG, IETSI and SNSG have high scores in applicability. In the meta-synthesis, the CPGs show similar recommendations, but there is variability in the indications for selective laser trabeculoplasty and MIGS. Abbreviations CPG Clinical Practice Guidelines HTA Health technology assessment OAG Open Angle Glaucoma POAG Primary Open Angle Glaucoma AGREE-II Appraisal of Guidelines for Research and Evaluation MIGS Minimally invasive glaucoma surgery IOP Intraocular pressure AOA American Optometric Association APGG Asia Pacific Glaucoma Guideline FCCG Finnish Current Care Guideline for diagnostics, treatment and follow-up of primary open-angle glaucoma, normal-tension glaucoma and pseudoexfoliative glaucoma NSG Nordic and Swedish guidelines for the management of open-angle glaucoma JGSG The Japan Glaucoma Society guidelines for glaucoma − 5th edition NICE National Institute for Health and Care Excellence EGS European Glaucoma Society EGS-5-TGG Terminology and Guidelines for Glaucoma (5th edition) IETSI Instituto de Evaluación de Tecnologías en Salud e Investigación – EsSalud, Perú PPP Preferred Practice Pattern POAG-PPP Primary Open-Angle Glaucoma Preferred Practice Pattern® SNSG Sistema Nacional de Salud Guideline MaHTAS Malaysian Health Technology Assessment Section GDG Guideline Development Group GRADE Grading of Recommendations, Assessment, Development, and Evaluations CCT Corneal Central Thickness SAP Standard Automated Perimetry OCT Optical Coherence Tomography PGA Prostaglandin Analogues NPDS Non-Penetrating Deep Sclerectomy GDD Glaucoma Drainage Devices OHT Ocular Hypertension VF Visual Field COAG Chronic Open Angle Glaucoma KDB Kahook Dual Blade GATT Gonioscopy Assisted Transluminal Trabeculotomy ABiC Ab-interno Canaloplasty SEAGIG South East Asia Glaucoma Interest Group AAO American Academy of Ophthalmology COS Canadian Ophthalmological Society SLT Selective Laser Trabeculoplasty ALT Argon laser trabeculoplasty LIGHT Laser in Glaucoma and Ocular Hypertension SALT Steroids after Laser Trabeculoplasty NAM Number of antiglaucoma medication AM Antiglaucoma medication Declarations Conflict of interest: JGO has received speaker fees of Esteve, Novelty Technology Care and Angelini. JGO has received Travel and meeting support from Esteve, Bausch and Lomb, Thea, Equipsa, Alcon, Zeiss, Angelini, Brudylab, Salvat, and Sifi. RBE has received Travel and meeting support from Bayer, Salvat, Zeiss, Angelini, Thea, Roche, Alcon, Esteve and AbbVie. ISO have nothing to disclose. SBU has received travel and meeting support from Thea. RMB has received meeting support from Lansier, Ophtha and Saval. CBM has received Travel and meeting support from Bausch and Lomb. TGO has received speaker fees of Medica del Pacifico. Author Contribution Statement JGO: Conceptualization, Validation, Formal analysis, Investigation, Data Curation, Writing - Original Draft, Writing - Review & Editing. RBE: Validation, Formal analysis, Investigation, Data Curation, Writing - Original Draft, Writing - Review & Editing. ISO: Validation, Formal analysis, Investigation, Data Curation, Writing - Review & Editing. SBU: Validation, Formal analysis, Investigation, Data Curation, Writing - Review & Editing. RMB: Validation, Formal analysis, Investigation, Data Curation, Writing - Review & Editing. CBM: Validation, Investigation, Data Curation, Writing - Original Draft, Writing - Review & Editing. TGO: Conceptualization, Investigation, Writing - Review & Editing. Supplementary Information Supplementary information is available at eye’s website Funding: Self-funded. References European Glaucoma Society. Terminology and Guidelines for Glaucoma. 5th edition. 2021. Gallo Afflitto G, Aiello F, Cesareo M, Nucci C. Primary Open Angle Glaucoma Prevalence in Europe: A Systematic Review and Meta-Analysis. J Glaucoma. 2022;31(10):783–8. Institute of Medicine. Clinical practice guidelines we can trust. Washington DC: The National Academies Press; 2011. Prum BE, Rosenberg LF, Gedde SJ, Mansberger SL, Stein JD, Moroi SE, et al. Primary Open-Angle Glaucoma Preferred Practice Pattern(®) Guidelines. Ophthalmology. 2016;123(1):P41-111. Gedde SJ, Vinod K, Wright MM, Muir KW, Lind JT, Chen PP, et al. 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Denomination Title Year of Publication Organization Language AOA (20) Care of the Patient with Primary Open-Angle Glaucoma 2024 American Optometric Association (AOA) Evidence-based Optometry Guideline Development Group English APGG (7) Asia Pacific Glaucoma Guideline 2024 Asian Pacific Glaucoma Society English FCCG (21) Finnish Current Care Guideline for diagnostics, treatment and follow-up of primary open-angle glaucoma, normal-tension glaucoma and pseudoexfoliative glaucoma 2024 ( 2023 ****) Finnish Medical Society Duodecim, the Finnish Association of Ophthalmologists and the Finnish Glaucoma Society - Finland English/Finnish NSG (23) Nordic and Swedish guidelines for the management of open-angle glaucoma 2024 ( 2022 ***) Swedish ophthalmological society – Sweden English/Swedish JGSG (25) The Japan Glaucoma Society guidelines for glaucoma - 5th edition 2023 ( 2022* *) Japan Glaucoma Society – Japan Japanese/English NICE (27) Glaucoma: diagnosis and management 2022 ( 2017 *) National Institute for Health and Care Excellence (NICE) – United Kingdom English EGS-5-TGG (1) Terminology and Guidelines for Glaucoma (5th edition) 2021 European Glaucoma Society-Europe English/Spanish IETSI (28) Guía de Práctica Clínica para el manejo de Glaucoma de Ángulo Abierto 2021 Instituto de Evaluación de Tecnologías en Salud e Investigación - EsSalud – Perú Spanish POAG-PPP-2020 (5) Primary Open-Angle Glaucoma Preferred Practice Pattern® 2020 American Academy of Ophthalmology – United States of America English SNSG (29) Guía de Práctica Clínica sobre Glaucoma de Ángulo Abierto 2017 Ministerio de Sanidad, Servicios Sociales e Igualdad de España and Agència de Qualitat i Avaluació Sanitàries de Catalunya - Spain Spanish MaHTAS (30) Management of Glaucoma 2017 Malaysian Health Technology Assessment Section Medical Development Division, Ministry of Health - Malaysia English **** Published in Finnish in March 2023 *** Published in Swedish in September 2022 **Published in Japanese in February 2022 * Last updated: 26 January 2022 AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Table 2: Characteristics of CPG for the diagnosis and management of open angle glaucoma. Characteristic Subcharacteristic AOA APGG a FCCG NSG JGSG NICE EGS-5-TGG IETSI POAG-PPP-2020 SNSG MaHTAS Guideline status New Update Update Update Update Update Update New Update New Update Developer organization Society Society Society and PO PO Society PO Society PO Society PO PO Funding Yes Yes Yes NR Yes NR NR Yes Yes Yes Yes Development group Number 28 44 10 8 25 9*(25**) 54 14 9 16 16 Affiliation details Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Specialty/sub-specialty details No No No No No Yes No Yes No Yes Yes Non-physician specialist Yes No NR NR No Yes NR Yes NR Yes Yes Population representative Yes No NR**** No No Yes NR No NR Yes No Methodologist Yes No NR NR NR Yes Yes Yes Yes Yes Yes External review Yes Yes NR NR NR Yes Yes Yes Yes Yes Yes General features Objective Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Scope Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Target users Yes Yes No No No Yes Yes Yes Yes Yes Yes Population Yes Yes Yes No No Yes Yes Yes Yes Yes Yes Evidence searches Search strategy Yes No No No No Yes No Yes Yes Yes Yes Number of referenced citations 508 707 173 3 302 170 117 27 243 147 123 Update Previous guide NA 2016 2014 2012 2017 2009 2014 NA 2015 NA 2008 Next update 2026-2029*** NR NR NR NR NR NR 2024*** 2025 NR 2021 Detailed declaration of conflict of interest Yes Yes Yes NR Yes Yes No Yes Yes Yes No Monitoring and/or auditing criteria Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Evidence and grading of recommendations NR NR GRADE NR GRADE± GRADE GRADE GRADE GRADE GRADE GRADE Clinical questions in the CPG 0 0 9 0 14 1***** 16 8 0 38 16 NR: Not reported NA: Not applicable. PO: Public Organization *2021 Guideline Update Committee **2017 Guideline Committee members and NGC technical team members ***Based on their update plan ****Not reported in the Guideline Development Group (GDG), but considered in during the development. *****1 question for the updated version. a: CPG with no free access. Available through Santen Pharmaceuticals, owner of the rights to distribute it. AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Table 3: Domain s cores (%) Domain AOA APGG FCCG NSG JGSG NICE EGS-5-TGG IETSI POAG-PPP-2020 SNSG MaHTAS MEAN 1: Scope and Purpose 52.2% 32.2% 83.3% 31.1% 37.8% 92.2% 82.2% 72.2% 37.8% 96.7% 77.8% 63.2% 2: Stakeholder Involvement 66.7% 27.8% 41.1% 15.6% 18.9% 80.0% 66.7% 53.3% 43.3% 88.9% 64.4% 51.5% 3: Rigour of Development 63.8% 11.3% 41.3% 5.8% 25.8% 92.1% 30.4% 77.5% 39.2% 75.8% 44.2% 46.1% 4: Clarity of Presentation 91.1% 73.3% 60.0% 47.8% 65.6% 97.8% 88.9% 78.9% 42.2% 94.4% 73.3% 73.9% 5: Applicability 31.7% 12.5% 40.0% 29.2% 21.7% 80.0% 36.7% 56.7% 41.7% 61.7% 63.3% 43.2% 6: Editorial Independence 35.5% 45.0% 55.0% 0% 35.0% 90.0% 0% 58.3% 86.7% 80% 38.3% 47.6% Overall Guideline Assessment 3 3 3 2 3 6 4 3 3 5 4 3,5 Recommendation No No No No No Yes, w/o modif. Yes, w/ modif. No No Yes, w/ modif. Yes, w/ modif. - AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Table 4: Summary of Appraisers’ Comments on the Open Angle Glaucoma Clinical Practice Guidelines assessed, organized by AGREE II Domains AGREE II domain Strength Weaknesses 1. Scope and Purpose The objective is well defined (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG partially in JGSG, NSG, APGG, AOA). The health questions are covered (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG, partially in JGSG, AOA). Population to whom the guideline is meant to apply is described (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA partially in EGS-5-TGG, FCCG). Health questions are not specifically described (POAG-PPP-2020, JGSG, NSG, APGG). No description of excluded populations is available (IETSI, POAG-PPP-2020, JGSG, NSG, APGG). Population to whom the guideline is meant to apply is not described (JGSG, NSG, APGG). 2. Stakeholder Involvement Guideline development group included individuals from relevant professional groups: clinical and methodological (NICE, POAG-PPP-2020, SNSG, MaHTAS, JGSG, AOA, partially in NSG, FCCG). Views and preferences of the target population were addressed (NICE, SNSG, FCCG, AOA, partially in EGS-5-TGG). Target users were reported (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, APGG, AOA). Guideline development group partially describes the expertise, institution, geographical location, or member’s role (EGS-5-TGG, APGG, AOA). Does not include patient representatives (IETSI, NSG, JGSG, APGG). The views and preferences of the target population have not been sought (IETSI, POAG-PPP-2020, MaHTAS, NSG, JGSG, APGG). No description about discipline/content expertise, institution, or geographical location was reported (POAG-PPP-2020). No report of target users (FCCG, NSG) 3. Rigor of development Details of the strategy used were reported (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA, partially in NSG). The criteria for selecting the evidence are clearly described (NICE, IETSI, partially in POAG-PPP-2020, SNSG, MaHTAS, JGSG, FCCG, AOA). Strengths and limitations of the body of evidence are clearly described (NICE, IETSI, SNSG, MaHTAS, partially in JGSG, AOA). Methods for formulating the recommendations are described (IETSI, AOA, partially in SNSG, MaHTAS, JGSG and FCCG). The health benefits, side effects, and risks have been considered in formulating the recommendations (NICE, IETSI, SNSG, JGSG, AOA, partially in APGG). There is an explicit link between the recommendations and the supporting evidence (NICE, IETSI, SNSG, FCCG, AOA, partially in JGSG, APGG). The guideline has been externally reviewed by experts prior to its publication (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA). A procedure for updating the guideline was provided (IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA, partially in NICE). No details of the strategy used were reported (JGSG, APGG). Did not carry out systematic searches for costs, outcomes assessment by patients, feasibility, or implementation (IETSI, JGSG, APGG). The methods for formulating the recommendations are partially described (NICE, FCCG, APGG). Strengths and limitations of the body of evidence, methods for formulating recommendations, are not clearly described (POAG-PPP-2020, JGSG, FCCG, APGG). Health benefits, side effects, and risks in formulating recommendations, have not been reported (MaHTAS). There is no explicit link between the recommendations and the supporting evidence (MaHTAS, POAG-PPP-2020). A procedure for updating the guideline is not provided (EGS-5-TGG, JGSG, APGG). Guideline wasn’t externally reviewed (JGSG). Most of the domain items were not reported or free available (EGS-5-TGG, NSG). Guideline was externally reviewed, but external reviewers’ comments are not available (EGS-5-TGG, APGG). 4. Clarity of presentation Recommendations are specific and unambiguous (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA). The different options for management of the condition or health issue are clearly presented (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA). Key recommendations are easily identifiable (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, NSG, APGG, partially FCCG, AOA). Does not include several clinical issues relevant to glaucoma (IETSI). 5. Applicability Describes facilitators and barriers to its application (IETSI, MaHTAS, NICE, AOA, partially in SNSG, POAG-PPP-2020, NSG, APGG). Provides advice and/or tools on how the recommendations can be put into practice (NICE, IETSI. POAG-PPP-2020, SNSG, MaHTAS, FCCG, partially in AOA). Potential resource implications of applying the recommendations have been considered (NICE, EGS-5-TGG, POAG-PPP-2020, SNSG, FCCG, AOA). Presents clinical monitoring criteria (NICE, IETSI, MaHTAS, SNSG, partially reported (only clinical criteria) in EGS-5-TGG, POAG-PPP-2020, JGSG, NSG, FCCG, AOA). No description of how the information influenced the guideline development process and/or formation of the recommendations (NICE, JGSG, NSG, APGG). Does not describe facilitators and barriers to its application (EGS-5-TGG, JGSG, FCCG, APGG). Potential resource implications have not been considered (IETSI, MaHTAS, JGSG, NSG, APGG). No clinical monitoring criteria present (APGG) 6. Editorial independence Competing interests of guideline development group members have been recorded and addressed (NICE, IETSI, POAG-PPP-2020, SNSG, JGSG, FCCG, APGG, AOA). Guideline report details about funding body (MaHTAS, APGG, partially in AOA). No description about funding body or competing interests of guideline development group is available (EGS-5-TGG, NSG) There’s no statement that the views of the funding body have not influenced the content of the guideline (all guidelines). Competing interest of guideline development group are not described (MaHTAS, NSG). 7. Overall Guideline Assessment Recommended: No: AOA, APGG, FCCG, NSG, JGSG, IETSI, POAG-PPP-2020 Yes, with modifications: EGS-5-TGG, SNSG, MaHTAS Yes, without modifications: NICE *Comments specific to certain CPGs are indicated in parentheses; comments lacking denotations pertain to all eleven CPGs. AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Table 5: Recommendations Matrix of clinical practice guidelines for the diagnosis and management of OAG (Guideline clinical recommendation meta-synthesis). AOA (2024) APGG (2024) FCCG (2024) NSG (2024) JGSG (2023) NICE (2022) EGS-5-TGG (2021) IETSI (2021) POAG-PPP-2020 (2020) SNSG (2017) MaTHAS (2017) Risk factors /predictors Ocular Elevated IOP, myopia, corneal thickness, corneal hysteresis Higher IOP, thinner central cornea, myopia Age, IOP, pseudo exfoliation with Ocular Hypertension (OHT), optic nerve head hemorrhage, myopia Elevated IOP, exfoliation syndrome, moderate to high myopia, optic disc hemorrhages, pigment dispersion syndrome, thin CCT Elevated IOP, thin CCT, large C/D ratio, small optic nerve rim area, disc hemorrhage, large β-zone of peripapillary chorioretinal atrophy, low corneal hysteresis, low ocular perfusion pressure Level of IOP, CCT Elevated IOP, disc hemorrhage, myopia Elevated IOP, myopia Elevated IOP, thin CCT, myopia, low ocular perfusion pressure Elevated IOP, myopia Elevated and/or asymmetry of IOP, thinner CCT, myopia, corneal hysteresis Other Increasing age, genetics and positive family history, race/ethnicity, type 2 diabetes mellitus, hypertension/hypotension Older age, family history of glaucoma, race or ethnicity (Hispanics/Latinos, Africans and South Central Asians), low diastolic perfusion pressure (<50 mmHg) Family history of glaucoma, African ancestry, reduced perfusion pressure Older age, family history, non-Caucasian ethnicity (mainly African), low diastolic blood pressure Age, family history of glaucoma, low diastolic and systolic blood pressure, type 2 diabetes, exfoliation syndrome, poor drug adherence Family history, life expectancy Older age, non-White ethnicity (particularly Black), family history of glaucoma, pseudo exfoliation, low diastolic blood pressure Older age, black and/or hispanic ethnicity, family history of glaucoma, diabetes Older age, family history of glaucoma, African race or Latino/Hispanic ethnicity, type 2 diabetes Age, ethnicity (predominantly black), diabetes, family history of glaucoma Older age; West African, Afro-Caribbean or Hispanic/Latino ethnicity; positive family history, Obstructive Sleep Apnea Syndrome, diabetes mellitus Screening The evidence is insufficient to assess the benefits and harms of glaucoma screening in asymptomatic adults. Screening in the general population has not been found to be cost-effective. In the general population is not recommended In certain populations with a high risk of glaucoma blindness and low screening costs, community-based screening can be cost-effective. Not Recommended NC NC NC Not Recommended NC Screening is more useful and cost-effective when it is targeted at populations at high risk of glaucoma It is suggested to perform glaucoma screening in patients with risk factors for developing the disease Should be considered for patients with risk factors, especially: age >40 years, family history of glaucoma, diabetes mellitus Target IOP May change depending on the results of long-term monitoring Target IOP should be individualized and reviewed at every follow-up visit based on disease severity, rate of progression, and life expectancy. Adjusted at each follow-up Continuously evaluated and adjusted Set according to the stage of glaucoma Prefer ‘clinically acceptable control of IOP’ Updated at each monitoring Target IOP will be determined and adjusted individually for each patient based on the treating physician´s criteria and periodic reevaluation Individualized and adjusted further down or even up during the disease It is reasonable to aim for a 25 to 50% reduction in baseline IOP without treatment, depending on the level of PIO, stages, age, presence of risk factors, rate of progression Individualized and adjusted during the disease Central corneal thickness (CCT) correction Is indicated as part of the evaluation of the patient with suspected glaucoma or ocular hypertension No No No No No No NC No NC No Gonioscopy Yes. Anterior segment-optical coherence tomography should not serve as a replacement for gonioscopy Yes. OCT-A can more precisely evaluate iris trabecular contact (ITC) in 360° compared with gonioscopy. Cannot be replaced by automated imaging Yes Yes, static and dynamic If not available, use OCT or Van Herick. Yes Yes. Use UBM exceptionally Yes If impossible, choose Van Herick Yes, static and dynamic Standard Automated Perimetry (SAP) Is a fundamental test for detecting visual field loss and for monitoring the rate of visual field change over time A personalized testing strategy is advisable. This tailored approach ensures that each patient receives optimal care tailored to their specific condition Factors such as disease stage, patient’s age, and current progression status should guide the frequency of VF testing Use the same instrument and protocol for follow-up. 2-6 VF are needed to confirm progression. In advanced glaucoma monitor progression with central 10-degree VF 5–6 Visual Field (VF) during the first 2 years, except patients with newly discovered OHT. Adapt the stimulus intensity and size according to the stage of glaucoma. Minimum of 5 VF to determine progression. Newly diagnosed glaucoma: measure as frequently as possible during the first 2 years. Establish a baseline and severity of impairment at diagnosis 3 times per year during the first 2 years in newly diagnosed patients Yes Repeat the same strategy that showed a new glaucomatous defect to confirm VF damage progression. Minimum of 6 VF in the first 2 years of diagnosis to calculate rate and progression Change stimulus size and strategy in advanced disease OCT for diagnosis and follow-up Yes. Is useful for documenting the status and progression OCT is a complementary tool rather than a replacement for a comprehensive clinical evaluation. Do not diagnose or assess progression based on OCT alone. Examinations with different devices are not comparable. Repeated examinations may show false positive progression. Floor effect in advanced glaucoma complicates assessment. Suitable for early stages. Not recommended in advanced glaucoma (floor effect) Useful for baseline documentation Don't diagnose solely on OCT Yes Yes Yes Yes Management Laser trabeculoplasty as first line treatment Yes Yes Yes Yes No: It is used as an alternative treatment for patients who cannot achieve target IOP using drug therapy Yes Yes No: If bad adherence to pharmacological treatment is expected Yes No: If bad pharmacological treatment adherence is expected. Don't associate with pharmacological treatment in patients with uncontrolled glaucoma. Yes Prostaglandin analogues (PGA) as first-line drug Yes Yes Yes. Yes Yes Yes Yes Yes Yes Yes Yes Other considerations Patients prescribed topical IOP lowering therapy may experience decreased tear film stability and elevated tear osmolarity and should be evaluated for ocular surface disease New medications and classes of drugs have been developed recently (selective EP2 receptor agonist and Rho kinase inhibitors), broadening our treatment options Beta blocker can be chosen as first line treatment. Fixed combination of PGA and beta blocker reduce IOP more than other combinations. For good adherence, a fixed combination is usually chosen Drug therapy is the first -line treatment for primary open-angle glaucoma. Do not offer treatment to people with suspected chronic open angle glaucoma (COAG) and IOP less than 24 mmHg unless they are at risk of visual impairment within their lifetime. Advise people to continue regular visits to their primary eye care professional. Fixed combination is preferable to multiple drugs Start treatment with two drugs in patients with high initial IOP Fixed combinations are not recommended for initial treatment In people with open-angle glaucoma, initial treatment with beta-blockers is recommended if prostaglandin analogues cannot be used Fixed combinations provide improved long-term adherence compared with non-fixed components Laser trabeculoplasty or Surgery indication NC Medical therapy failure in achieving optimal IOP control If insufficient response, intolerance to treatment or progression, despite lowered IOP If more than 3 drugs are required to achieve target IOP When multiple medications are required After treatment with medicines from 2 therapeutic classes When insufficiently controlled with two or three agents NC NC Consider if there is no response to medical treatment, or if there is progression If more than two medications are required to achieve target IOP Surgery Trabeculectomy Is therefore a long-term management option for IOP control The procedure is conventionally considered the gold standard of penetrating surgery to create a subconjunctival bleb without the need of an implant, resulting in a cost-effective approach to the surgical treatment of glaucoma. Is the most performed glaucoma filtering surgery. Complication’s area more frequent than in non-penetrating surgeries Gold standard Initial treatment for patients with inadequate control of IOP by drug therapy or laser therapy or for severe cases Offer people with advanced chronic open angle glaucoma (COAG), glaucoma surgery with pharmacological augmentation (Mitomycin C - MMC) as indicated When other forms of therapy have failed to control the disease or are not suitable; and target pressure is unlikely to be achievable with topical medications and/or laser. Adults with primary open angle glaucoma (POAG) that do not meet target IOP despite maximum tolerated pharmacological/laser treatment, are not suitable for pharmacological/laser treatment, or present advanced glaucoma damage at diagnosis. Indicated when medications and appropriate laser therapy are insufficient to control disease; can be considered as initial therapy in selected cases. In severe glaucoma and in cases with a high risk of progression despite optimal medical treatment Primary surgery of choice in primary open angle glaucoma (POAG) Combined trabeculectomy with cataract surgery NC NC NC Better IOP lowering than cataract surgery alone, but lower success rate than filtering surgery alone Weakly recommended NC IOP reduction is more than phacoemulsification alone. Success rate is less than filtration surgery alone NC Not as effective as glaucoma surgery alone in lowering IOP NC Significantly lower mean IOP than phacoemulsification alone MIGS General information about characteristics. Mention Trabectome surgery used in combination with cataract surgery Offer indications for use, recommendations enhance the success of implantation and recommendations postoperative management for trabecular meshwork MIGS (stents and procedures). Brief comment about MIGS. No evidence of the efficacy compared to traditional glaucoma surgery General information about characteristics, classification, and indications. Suitable in early or moderate glaucoma. Not sufficient information on long-term effects and safety Procedure should be performed by a surgeon with sufficient experience in anterior chamber angle surgery. Mentions: EX-PRESS, ab interno trabeculotomy (with metal hook, nylon thread or, trabectome) and iStent. NC A list of available techniques. Mild to moderate glaucoma. It is possible to combine it with phacoemulsification. Doesn't precise specific techniques. NC Description list of techniques. Some are only FDA approved to be performed concurrently with phacoemulsification. Less effective in lowering IOP than trabeculectomy and GDD. More favorable safety profile in the short term. Mentions: Trabectome, KDB, GATT with iTrack or suture, ABiC, iStent and iStent inject, Hydrus microstent, Xen gel stent. Lack of descriptions and recommendations Not recommended Non-penetrating deep sclerectomy (NPDS) NC Non-penetrating glaucoma surgery (NPGS) reduces IOP less effectively than penetrating surgery, but with lower complication rates. NPGS may reduce the hypotony risks of trabeculectomy in higher- risk patients, e.g., high myopes, younger patients, previous vitrectomy, eye-rubbers. Surgeon preference based on training and experience determines the preferred procedure (NPGS versus trabeculectomy) for the particular patient Brief comment NC Brief comment NC Brief comment NC Description of technique and brief comment about Deep sclerectomy Description of technique and offers recommendations (1 general and 4 specific) Brief comment Glaucoma drainage devices (GDD) Baerveldt GDDs resulted in greater IOP reduction but more early and serious complications than was encountered with patients receiving Ahmed valves Indications: previous failed trabeculectomy with antimetabolites, insufficient conjunctiva due to scarring, complicated and refractory glaucomas. Non-valved drainage devices result in greater postoperative hypotony than valved devices Higher success rate than trabeculectomy in eyes with previous intraocular surgery First-line surgical procedure in some cases Patients with unsuccessful trabeculectomy with concomitant use of antimetabolites, severe conjunctival scarring because of previous surgery, those who are unlikely to achieve successful trabeculectomy or technically cannot undergo other filtration procedures. Less effective in lowering IOP than trabeculectomy NC Patients with risk factors for a poor result of trabeculectomy with antifibrotics. Potential role as a primary surgical procedure in selected cases. Patients who do not meet target IOP or evidence a progression in visual field damage despite maximum tolerated pharmacological treatment and trabeculectomy, or when trabeculectomy has a high failure rate. Indicated when trabeculectomy has failed to control IOP or is deemed unlikely to succeed. Use patch allografts of sclera, cornea, or pericardium to prevent tube erosion. Patients that have not controlled IOP despite pharmacological treatment, or when filtering surgery has failed. GDDs are not the first choice of surgical treatment in naïve patients. Patients with high risk of failure from augmented trabeculectomy Lens extraction For patients with POAG results in a modest IOP decrease (13%), reduced medication requirement (12%). Some patients (up to 26%), however, experience worse IOP control and may require additional medications, laser surgery or both There is insufficient evidence to support that IOP reduction from cataract surgery can protect against VF deterioration. Might impair the filtration of a previous glaucoma surgery. The risk is lower if there is a time gap of over 12 months between surgeries. Consider early cataract surgery in patients with glaucoma. NC NC Cataract surgery alone as an intervention to control glaucoma is not recommended. Performed after trabeculectomy can affect the IOP control. NC Multifocal intraocular lenses may have adverse effects on contrast sensitivity and visual field performance in patients with glaucoma. NC The risk of bleb failure is reduced if lens extraction is performed > 6 months post-trabeculectomy. Cyclodestructive procedures Patients treated with endocyclophotocoagulation via the pars plana had lower IOPs, needed fewer glaucoma medications, and had a higher success than patients similarly treated via the limbus Both forms of diode lasers ( micropulse and standard) are effective forms of trans-scleral cyclophotocoagulation of ciliary body ablation. MicroPulse is thought to be safer, but less efficacious in terms of IOP lowering compared with standard cyclodiode. The technique chosen is based on surgeon preference and equipment availability Effective and safe in difficult-to-treat glaucoma. Repeated treatments are often required. When filtering surgery has not worked/is not effective enough or not feasible and in painful blind eyes Refractory cases in which other treatments are ineffective because it can cause vision threatening complications Offer cyclodiode laser treatment to people with chronic open angle glaucoma (COAG) (including advanced COAG) who prefer not to have glaucoma surgery or whom glaucoma surgery is not suitable Indicated when filtration surgery or GDD are likely to fail/have failed/are not feasible; and in refractory glaucoma Adults with primary open angle glaucoma (POAG) that don't meet target IOP despite treatment, patients that cannot have glaucoma drainage devices (GDD) implanted, and in painful blind eye Eyes with limited visual potential or that are otherwise poor candidates for incisional ocular surgery NC Indicated in painful blind eyes or eyes with poor vision, failed multiple filtering surgeries. May be performed in sighted eyes when the benefits outweigh the risks for incisional surgery. Other issues Patient education and adherence Recommended. Eye doctors should be persistent in providing education and training to improve adherence/compliance with recommended therapy Recommended. Adherence can be improved by identifying the barriers and addressing them strategically It is unclear whether patient education improves compliance Recommended. Glaucoma schools create affinity and exchange of experience between patients Recommended Recommended Recommended NC Recommended. Peer-support groups or counseling are helpful to some patients. Recommended Recommended Pregnancy and breastfeeding Pharmacological treatment of POAG should be used with caution during pregnancy and lactation Present or possible, renders all interventions potentially hazardous Discuss with the doctor that is treating the pregnancy whether to star treatment or to monitor without treatment NC Drug therapy for glaucoma should be discontinued during pregnancy, childbirth, and lactation. Laser therapy or surgery should be considered if IOP control worsens upon discontinuation of the drug. There are no glaucoma medications for which safety has been established in pregnant women, fetuses, or nursing mothers. Specific consideration in terms of discussions about management and pharmacological treatment. Temporary treatment discontinuation can be considered. No IOP-lowering medications have been labeled for use during pregnancy and/or breastfeeding. Systemic absorption should be reduced by punctal occlusion and eyelid closure. During breastfeeding, PGAs, carbonic anhydrase inhibitors and beta-blockers may be acceptable. NC The American Academy of Pediatrics has approved the use of carbonic anhydrase inhibitors during lactation. Brimonidine can cause apnea in infants, toddlers, and children; therefore, is not recommended to be used in mothers who are breastfeeding. Vaginal delivery is not contraindicated and must only be evaluated in cases of severe or advanced glaucoma. The ideal for newborn child, who is breastfed, is that de mother can control herself without medical treatment because all drugs can pass through the milk Topical beta-blockers can be the first-line medications when considering medical treatment of glaucoma in pregnancy. NC: Not covered AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline NSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence EGS: European Glaucoma Society IETSI: Instituto de Evaluación de Tecnologías en Salud e Investigación PPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline MaHTAS: Malaysian Health Technology Assessment Section Additional Declarations There is conflict of interest Supplementary Files Supplementaryinformation.docx Supplementary information Cite Share Download PDF Status: Published Journal Publication published 29 Sep, 2025 Read the published version in Journal of Glaucoma → Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4843576","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":398389936,"identity":"e05be334-1314-4e14-983a-a4eca22eded1","order_by":0,"name":"Jose 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information","description":"","filename":"Supplementaryinformation.docx","url":"https://assets-eu.researchsquare.com/files/rs-4843576/v2/e58498a249831ca941bffc23.docx"}],"financialInterests":"There is conflict of interest","formattedTitle":"Systematic review of clinical practice guidelines for the diagnosis and management of open angle glaucoma","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eOpen angle glaucoma(OAG) is a \u0026ldquo;chronic, progressive, potentially blinding, irreversible eye disease causing optic nerve rim and retinal nerve fiber layer loss with related visual field defects\u0026rdquo;; characterized by a normal angle, associated with several risk factors(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), with a prevalence in Europe of 2.60%(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). A timely diagnosis and treatment are relevant to avoid a progression leading to irreversible blindness as it enlightens in several clinical practice guidelines.\u003c/p\u003e \u003cp\u003eClinical practice guidelines (CPG) are \u0026ldquo;systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances\u0026rdquo;(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). CPG for the diagnosis and management of glaucoma have evolved through the years, with different editions developed by organizations like American-Academy-of-Ophthalmology(Preferred-Practice-Pattern-2016(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) and 2020(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)), European-Glaucoma-Society (Terminology and Guidelines 4th (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) and 5th edition(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)) and Asia-Pacific-Glaucoma Society (3rd (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) and 4th (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) edition).\u003c/p\u003e \u003cp\u003eThe most applied method to assess CPG methodological quality is the \u0026ldquo;Appraisal of Guidelines for Research \u0026amp; Evaluation\u0026rdquo;(AGREE) Instrument(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Several studies have assessed the quality of CPG in primary open angle glaucoma(POAG)(\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e), minimally invasive glaucoma surgery(MIGS)(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and childhood glaucoma(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The aim of this paper was to assess the methodological quality of CPG for the diagnosis and management of OAG.\u003c/p\u003e"},{"header":"MATERIAL AND METHODS","content":"\u003cp\u003eA systematic review of CPGs was conducted in compliance with methodology reports(\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), as well as previous studies carried out by our team(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Protocol was registered in the International Prospective Register of Systematic Reviews(PROSPERO:CRD42024510656).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSystematic literature search\u003c/h2\u003e \u003cp\u003eTwo authors(JGO and ISO) conducted a systematic literature search for OAG CPGs in November 2023, with no limitations by language or year of publication. A search update was run in November 2024(eTable 1 and eTable 2).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eCPG screening\u003c/h3\u003e\n\u003cp\u003eTwo authors(JGO and ISO) independently screened the titles and abstracts of identified records. Disagreements were resolved through discussion and reviewed by a third author(TGO).\u003c/p\u003e\n\u003ch3\u003eGuideline selection and data extraction\u003c/h3\u003e\n\u003cp\u003eCPGs were selected if they were written in English or Spanish, published within the last 7 years, and full text was available. CPG details were extracted and were not excluded on the basis of on overall quality. In the case of updated CPG, previous CPG(1 or 2 previous editions), supplements and additional files were searched, and data extracted.\u003c/p\u003e\n\u003ch3\u003eGuideline quality critical appraisal\u003c/h3\u003e\n\u003cp\u003eFive authors(JGO, SBU, RBE, RMB, CBM) critically appraised the quality of the guidelines using the AGREE II instrument(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eGuideline clinical recommendation meta-synthesis:\u003c/h3\u003e\n\u003cp\u003eA meta-synthesis of most clinically relevant recommendations was performed. Two authors with experience in glaucoma(SBU and RMB) extracted independently the key recommendations and built a recommendations matrix, reviewed by a third author(CBM). Selected recommendations items were reviewed additionally by a senior author with experience in glaucoma(TGO).\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eGuideline selection\u003c/h2\u003e \u003cp\u003eLiterature search through databases and meta-search engines retrieved 2944 records, from those, 1 955 were deleted using the duplicate detection tool of Rayyan web application. 989 records were screened by title and abstract using Rayyan web application, and 13 records were selected for full text review. Six articles were excluded because of the following reasons: wrong topic(n\u0026thinsp;=\u0026thinsp;4) and old version of included guidelines(n\u0026thinsp;=\u0026thinsp;2).\u003c/p\u003e \u003cp\u003e42 records were retrieved through GPGs developers or Ophthalmology organizations webpages. One CPG was retrieved from the \u0026ldquo;Gu\u0026iacute;aSalud del Sistema Nacional de Salud de Espa\u0026ntilde;a\u0026rdquo;(SNSG) and other from \u0026ldquo;Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u0026ndash;EsSalud, Per\u0026uacute;\u0026rdquo;(IETSI) webpage. Two CPG were retrieved from \u0026ldquo;Guideline Central\u0026rdquo;. Other CPGs were excluded because of the following reasons: language not English/Spanish(n\u0026thinsp;=\u0026thinsp;1), wrong topic(n\u0026thinsp;=\u0026thinsp;32) and already included(n\u0026thinsp;=\u0026thinsp;5). Manual search identified no additional study (eFig. 1).\u003c/p\u003e \u003cp\u003eFinally, eleven CPG were selected, developed by: the American-Optometric-Association(AOA) Evidence-based Optometry-Guideline-Development Group(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), the Asian-Pacific-Glaucoma-Society(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), the Finnish-Association-of-Ophthalmologists and the Finnish-Glaucoma-Society(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) published in English in January-2024 and in Finnish in March-2023(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), Swedish-Ophthalmological-Society(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) published in English in January-2024 and in Swedish in September-2022(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), Japanese-Glaucoma-Society(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) published in English in February-2023 and in Japanese in February-2022(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), National-Institute-for-Health-and-Care-Excellence(NICE)(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) first version published in 2017 with an update published in 2022, European-Glaucoma-Society(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), Instituto-de-Evaluaci\u0026oacute;n-de-Tecnolog\u0026iacute;as-en-Salud-e Investigaci\u0026oacute;n-EsSalud(IETSI)(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), American-Academy-of-Ophthalmology(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), Ministerio-de-Sanidad,Servicios-Sociales-e-Igualdad-de-Espa\u0026ntilde;a and Ag\u0026egrave;ncia-de-Qualitat-i-Avaluaci\u0026oacute; Sanit\u0026agrave;ries-de-Catalunya(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), and Malaysian-Health-Technology-Assessment-Section-Medical-Development-Division-Ministry-of-Health-Malaysia(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)(Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSelected CPG for the diagnosis and management of open angle glaucoma.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDenomination\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTitle\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYear of Publication\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLanguage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAOA (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCare of the Patient with Primary Open-Angle Glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAmerican Optometric Association (AOA) Evidence-based Optometry Guideline Development Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAPGG (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAsia Pacific Glaucoma Guideline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAsian Pacific Glaucoma Society\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFCCG (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinnish Current Care Guideline for diagnostics, treatment and follow-up of primary open-angle glaucoma, normal-tension glaucoma and pseudoexfoliative glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2024 (\u003cb\u003e2023\u003c/b\u003e****)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFinnish Medical Society Duodecim, the Finnish Association of Ophthalmologists and the Finnish Glaucoma Society - Finland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish/Finnish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNSG (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNordic and Swedish guidelines for the management of open-angle glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2024 (\u003cb\u003e2022\u003c/b\u003e***)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSwedish ophthalmological society \u0026ndash; Sweden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish/Swedish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJGSG (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe Japan Glaucoma Society guidelines for glaucoma \u0026minus;\u0026thinsp;5th edition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2023 (\u003cb\u003e2022*\u003c/b\u003e*)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJapan Glaucoma Society \u0026ndash; Japan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eJapanese/English\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNICE (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGlaucoma: diagnosis and management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2022 (\u003cb\u003e2017\u003c/b\u003e*)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNational Institute for Health and Care Excellence (NICE) \u0026ndash; United Kingdom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEGS-5-TGG (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTerminology and Guidelines for Glaucoma (5th edition)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEuropean Glaucoma Society-Europe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish/Spanish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIETSI (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGu\u0026iacute;a de Pr\u0026aacute;ctica Cl\u0026iacute;nica para el manejo de Glaucoma de \u0026Aacute;ngulo Abierto\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eInstituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n - EsSalud \u0026ndash; Per\u0026uacute;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSpanish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOAG-PPP-2020 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary Open-Angle Glaucoma Preferred Practice Pattern\u0026reg;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAmerican Academy of Ophthalmology \u0026ndash; United States of America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNSG (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGu\u0026iacute;a de Pr\u0026aacute;ctica Cl\u0026iacute;nica sobre Glaucoma de \u0026Aacute;ngulo Abierto\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMinisterio de Sanidad, Servicios Sociales e Igualdad de Espa\u0026ntilde;a and Ag\u0026egrave;ncia de Qualitat i Avaluaci\u0026oacute; Sanit\u0026agrave;ries de Catalunya - Spain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSpanish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaHTAS (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eManagement of Glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMalaysian Health Technology Assessment Section\u003c/p\u003e \u003cp\u003eMedical Development Division, Ministry of Health - Malaysia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEnglish\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e**** Published in Finnish in March 2023 *** Published in Swedish in September 2022 **Published in Japanese in February 2022\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e* Last updated: 26 January 2022\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eAOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eEGS: European Glaucoma Society IETSI: Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003ePPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of CPG for the diagnosis and management of open angle glaucoma.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"13\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubcharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAOA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAPGG\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFCCG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNSG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eJGSG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNICE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eEGS-5-TGG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eIETSI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003ePOAG-PPP-2020\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eSNSG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eMaHTAS\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGuideline status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNew\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNew\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eNew\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeveloper organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSociety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSociety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSociety and PO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSociety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSociety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003ePO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSociety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003ePO\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFunding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eDevelopment group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNumber\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9*(25**)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAffiliation details\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSpecialty/sub-specialty details\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNon-physician specialist\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePopulation representative\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR****\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMethodologist\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExternal review\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eGeneral features\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eObjective\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eScope\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eTarget users\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePopulation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvidence searches\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSearch strategy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNumber of referenced citations\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e173\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUpdate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePrevious guide\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e2008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNext update\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2026\u0026ndash;2029***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2024***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDetailed declaration of conflict of interest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonitoring and/or auditing criteria\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvidence and grading of recommendations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGRADE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eGRADE\u0026plusmn;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eGRADE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eGRADE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eGRADE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eGRADE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eGRADE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eGRADE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical questions in the CPG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1*****\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eNR: Not reported NA: Not applicable. PO: Public Organization\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003e*2021 Guideline Update Committee **2017 Guideline Committee members and NGC technical team members ***Based on their update plan\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003e****Not reported in the Guideline Development Group (GDG), but considered in during the development.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003e*****1 question for the updated version.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003ea: CPG with no free access. Available through Santen Pharmaceuticals, owner of the rights to distribute it.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eAOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eEGS: European Glaucoma Society IETSI: Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003ePPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eGuideline quality\u003c/h3\u003e\n\u003cp\u003eRegarding quality of evidence, most of the CPG used CPG used GRADE system for rating quality of evidence and grading recommendation(Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOf the six domains from AGREE-II(Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e), the lowest score was in domain 6-\u0026ldquo;Editorial independence\u0026rdquo;(EGS-5-TGG and NSG), and the highest score was in domain 4-\u0026ldquo;Clarity of Presentation\u0026rdquo;(NICE). NICE Guideline presented the best score in domain 3-\u0026ldquo;Rigour of development\u0026rdquo;(92.1%)(Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDomain scores (%)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"13\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomain\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAOA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAPGG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFCCG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNSG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eJGSG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNICE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEGS-5-TGG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIETSI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003ePOAG-PPP-2020\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSNSG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eMaHTAS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eMEAN\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1: Scope and Purpose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e92.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e82.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e72.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e37.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e96.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e77.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e63.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2: Stakeholder Involvement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.6%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e80.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e66.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e53.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e43.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e88.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e64.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e51.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3: Rigour of Development\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e92.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e30.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e77.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e39.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e75.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e44.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e46.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4: Clarity of Presentation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e65.6%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e97.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e88.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e78.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e42.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e94.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e73.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e73.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5: Applicability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e80.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e36.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e56.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e41.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e61.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e63.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e43.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6: Editorial Independence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e35.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e90.0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e58.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e86.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e38.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e47.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall Guideline Assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e3,5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecommendation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes, w/o modif.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes, w/ modif.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes, w/ modif.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes, w/ modif.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eAOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eEGS: European Glaucoma Society IETSI: Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003ePPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"13\"\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSummary of Appraisers\u0026rsquo; Comments on the Open Angle Glaucoma Clinical Practice Guidelines assessed, organized by AGREE II Domains\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAGREE II domain\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrength\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWeaknesses\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e1. Scope and Purpose\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e● The objective is well defined (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG partially in JGSG, NSG, APGG, AOA).\u003c/p\u003e \u003cp\u003e● The health questions are covered (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG, partially in JGSG, AOA).\u003c/p\u003e \u003cp\u003e● Population to whom the guideline is meant to apply is described (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA partially in EGS-5-TGG, FCCG).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e● Health questions are not specifically described (POAG-PPP-2020, JGSG, NSG, APGG).\u003c/p\u003e \u003cp\u003e● No description of excluded populations is available (IETSI, POAG-PPP-2020, JGSG, NSG, APGG).\u003c/p\u003e \u003cp\u003e● Population to whom the guideline is meant to apply is not described (JGSG, NSG, APGG).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e2. Stakeholder Involvement\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e● Guideline development group included individuals from relevant professional groups: clinical and methodological (NICE, POAG-PPP-2020, SNSG, MaHTAS, JGSG, AOA, partially in NSG, FCCG).\u003c/p\u003e \u003cp\u003e● Views and preferences of the target population were addressed (NICE, SNSG, FCCG, AOA, partially in EGS-5-TGG).\u003c/p\u003e \u003cp\u003e● Target users were reported (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, APGG, AOA).\u003c/p\u003e \u003cp\u003e● Guideline development group partially describes the expertise, institution, geographical location, or member\u0026rsquo;s role (EGS-5-TGG, APGG, AOA).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e● Does not include patient representatives (IETSI, NSG, JGSG, APGG).\u003c/p\u003e \u003cp\u003e● The views and preferences of the target population have not been sought (IETSI, POAG-PPP-2020, MaHTAS, NSG, JGSG, APGG).\u003c/p\u003e \u003cp\u003e● No description about discipline/content expertise, institution, or geographical location was reported (POAG-PPP-2020).\u003c/p\u003e \u003cp\u003e● No report of target users (FCCG, NSG)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e3. Rigor of development\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e● Details of the strategy used were reported (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA, partially in NSG).\u003c/p\u003e \u003cp\u003e● The criteria for selecting the evidence are clearly described (NICE, IETSI, partially in POAG-PPP-2020, SNSG, MaHTAS, JGSG, FCCG, AOA).\u003c/p\u003e \u003cp\u003e● Strengths and limitations of the body of evidence are clearly described (NICE, IETSI, SNSG, MaHTAS, partially in JGSG, AOA).\u003c/p\u003e \u003cp\u003e● Methods for formulating the recommendations are described (IETSI, AOA, partially in SNSG, MaHTAS, JGSG and FCCG).\u003c/p\u003e \u003cp\u003e● The health benefits, side effects, and risks have been considered in formulating the recommendations (NICE, IETSI, SNSG, JGSG, AOA, partially in APGG).\u003c/p\u003e \u003cp\u003e● There is an explicit link between the recommendations and the supporting evidence (NICE, IETSI, SNSG, FCCG, AOA, partially in JGSG, APGG).\u003c/p\u003e \u003cp\u003e● The guideline has been externally reviewed by experts prior to its publication (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA).\u003c/p\u003e \u003cp\u003e● A procedure for updating the guideline was provided (IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA, partially in NICE).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e● No details of the strategy used were reported (JGSG, APGG).\u003c/p\u003e \u003cp\u003e● Did not carry out systematic searches for costs, outcomes assessment by patients, feasibility, or implementation (IETSI, JGSG, APGG).\u003c/p\u003e \u003cp\u003e● The methods for formulating the recommendations are partially described (NICE, FCCG, APGG).\u003c/p\u003e \u003cp\u003e● Strengths and limitations of the body of evidence, methods for formulating recommendations, are not clearly described (POAG-PPP-2020, JGSG, FCCG, APGG).\u003c/p\u003e \u003cp\u003e● Health benefits, side effects, and risks in formulating recommendations, have not been reported (MaHTAS).\u003c/p\u003e \u003cp\u003e● There is no explicit link between the recommendations and the supporting evidence (MaHTAS, POAG-PPP-2020).\u003c/p\u003e \u003cp\u003e● A procedure for updating the guideline is not provided (EGS-5-TGG, JGSG, APGG).\u003c/p\u003e \u003cp\u003e● Guideline wasn\u0026rsquo;t externally reviewed (JGSG).\u003c/p\u003e \u003cp\u003e● Most of the domain items were not reported or free available (EGS-5-TGG, NSG).\u003c/p\u003e \u003cp\u003e● Guideline was externally reviewed, but external reviewers\u0026rsquo; comments are not available (EGS-5-TGG, APGG).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e4. Clarity of presentation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e● Recommendations are specific and unambiguous (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA).\u003c/p\u003e \u003cp\u003e● The different options for management of the condition or health issue are clearly presented (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA).\u003c/p\u003e \u003cp\u003e● Key recommendations are easily identifiable (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, NSG, APGG, partially FCCG, AOA).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e● Does not include several clinical issues relevant to glaucoma (IETSI).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e5. Applicability\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e● Describes facilitators and barriers to its application (IETSI, MaHTAS, NICE, AOA, partially in SNSG, POAG-PPP-2020, NSG, APGG).\u003c/p\u003e \u003cp\u003e● Provides advice and/or tools on how the recommendations can be put into practice (NICE, IETSI. POAG-PPP-2020, SNSG, MaHTAS, FCCG, partially in AOA).\u003c/p\u003e \u003cp\u003e● Potential resource implications of applying the recommendations have been considered (NICE, EGS-5-TGG, POAG-PPP-2020, SNSG, FCCG, AOA).\u003c/p\u003e \u003cp\u003e● Presents clinical monitoring criteria (NICE, IETSI, MaHTAS, SNSG, partially reported (only clinical criteria) in EGS-5-TGG, POAG-PPP-2020, JGSG, NSG, FCCG, AOA).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e● No description of how the information influenced the guideline development process and/or formation of the recommendations (NICE, JGSG, NSG, APGG).\u003c/p\u003e \u003cp\u003e● Does not describe facilitators and barriers to its application (EGS-5-TGG, JGSG, FCCG, APGG).\u003c/p\u003e \u003cp\u003e● Potential resource implications have not been considered (IETSI, MaHTAS, JGSG, NSG, APGG).\u003c/p\u003e \u003cp\u003e● No clinical monitoring criteria present (APGG)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e6. Editorial independence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e● Competing interests of guideline development group members have been recorded and addressed (NICE, IETSI, POAG-PPP-2020, SNSG, JGSG, FCCG, APGG, AOA).\u003c/p\u003e \u003cp\u003e● Guideline report details about funding body (MaHTAS, APGG, partially in AOA).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e● No description about funding body or competing interests of guideline development group is available (EGS-5-TGG, NSG)\u003c/p\u003e \u003cp\u003e● There\u0026rsquo;s no statement that the views of the funding body have not influenced the content of the guideline (all guidelines).\u003c/p\u003e \u003cp\u003e● Competing interest of guideline development group are not described (MaHTAS, NSG).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e7. Overall Guideline Assessment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eRecommended:\u003c/p\u003e \u003cp\u003e● No: AOA, APGG, FCCG, NSG, JGSG, IETSI, POAG-PPP-2020\u003c/p\u003e \u003cp\u003e● Yes, with modifications: EGS-5-TGG, SNSG, MaHTAS\u003c/p\u003e \u003cp\u003e● Yes, without modifications: NICE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e*Comments specific to certain CPGs are indicated in parentheses; comments lacking denotations pertain to all eleven CPGs.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eAOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eEGS: European Glaucoma Society IETSI: Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003ePPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eGuideline clinical recommendation meta-synthesis:\u003c/h2\u003e \u003cp\u003eA meta-synthesis of most clinically relevant recommendations is presented in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. Selected recommendations included; general features(risk factors, screening, target intraocular pressure(IOP), corneal central thickness(CCT) correction, gonioscopy, standard automated perimetry(SAP), optical coherence tomography(OCT) for follow-up, management(laser trabeculoplasty as first line treatment, prostaglandin analogues(PGA) as first drug, other considerations, surgery/laser trabeculoplasty indication,), surgery(trabeculectomy, combined trabeculectomy with cataract surgery, MIGS, glaucoma drainage devices(GDD), non-penetrating deep sclerectomy(NPDS), lens extraction, cyclodestructive procedures and other issues(patient education and adherence, pregnancy and breastfeeding).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRecommendations Matrix of clinical practice guidelines for the diagnosis and management of OAG (Guideline clinical recommendation meta-synthesis).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAOA\u003c/p\u003e \u003cp\u003e(2024)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAPGG\u003c/p\u003e \u003cp\u003e(2024)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFCCG (2024)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNSG (2024)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eJGSG\u003c/p\u003e \u003cp\u003e(2023)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNICE\u003c/p\u003e \u003cp\u003e(2022)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEGS-5-TGG \u003c/p\u003e \u003cp\u003e(2021)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIETSI\u003c/p\u003e \u003cp\u003e(2021)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003ePOAG-PPP-2020\u003c/p\u003e \u003cp\u003e(2020)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eSNSG\u003c/p\u003e \u003cp\u003e(2017)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eMaTHAS\u003c/p\u003e \u003cp\u003e(2017)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRisk factors /predictors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElevated IOP, myopia, corneal thickness, corneal hysteresis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigher IOP, thinner central cornea, myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge, IOP, pseudo exfoliation with Ocular Hypertension (OHT), optic nerve head hemorrhage, myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eElevated IOP, exfoliation syndrome, moderate to high myopia, optic disc hemorrhages, pigment dispersion syndrome, thin CCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eElevated IOP, thin CCT, large C/D ratio, small optic nerve rim area, disc hemorrhage, large β-zone of peripapillary chorioretinal atrophy, low corneal hysteresis, low ocular perfusion pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLevel of IOP, CCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eElevated IOP, disc hemorrhage, myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eElevated IOP, myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eElevated IOP, thin CCT, myopia, low ocular perfusion pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eElevated IOP, myopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eElevated and/or asymmetry of IOP, thinner CCT, myopia, corneal hysteresis\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncreasing age, genetics and positive family history, race/ethnicity, type 2 diabetes mellitus, hypertension/hypotension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOlder age, family history of glaucoma, race or ethnicity (Hispanics/Latinos, Africans and South Central Asians), low diastolic perfusion pressure (\u0026lt;\u0026thinsp;50 mmHg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFamily history of glaucoma, African ancestry, reduced perfusion pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOlder age, family history, non-Caucasian ethnicity (mainly African), low diastolic blood pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAge, family history of glaucoma, low diastolic and systolic blood pressure, type 2 diabetes, exfoliation syndrome, poor drug adherence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFamily history, life expectancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eOlder age, non-White ethnicity (particularly Black), family history of glaucoma, pseudo exfoliation, low diastolic blood pressure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eOlder age, black and/or hispanic ethnicity, family history of glaucoma, diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eOlder age, family history of glaucoma, African race or Latino/Hispanic ethnicity, type 2 diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eAge, ethnicity (predominantly black), diabetes, family history of glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eOlder age; West African, Afro-Caribbean or Hispanic/Latino ethnicity; positive family history, Obstructive Sleep Apnea Syndrome, diabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eScreening\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe evidence is insufficient to assess the benefits and harms of glaucoma screening in asymptomatic adults.\u003c/p\u003e \u003cp\u003eScreening in the general population has not been found to be cost-effective.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIn the general population is not recommended\u003c/p\u003e \u003cp\u003eIn certain populations with a high risk of glaucoma blindness\u003c/p\u003e \u003cp\u003eand low screening costs, community-based screening can be cost-effective.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot Recommended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNot Recommended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eScreening is more useful and cost-effective when it is targeted at populations at high risk of glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eIt is suggested to perform glaucoma screening in patients with risk factors for developing the disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eShould be considered for patients with risk factors, especially: age\u0026thinsp;\u0026gt;\u0026thinsp;40 years, family history of glaucoma, diabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTarget IOP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMay change depending on the results of long-term monitoring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTarget IOP should be individualized and reviewed at every follow-up visit based on disease severity, rate of progression, and life expectancy.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdjusted at each follow-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eContinuously evaluated and adjusted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSet according to the stage of glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePrefer \u0026lsquo;clinically acceptable control of IOP\u0026rsquo;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUpdated at each monitoring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eTarget IOP will be determined and adjusted individually for each patient based on the treating physician\u0026acute;s criteria and periodic reevaluation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eIndividualized and adjusted further down or even up during the disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eIt is reasonable to aim for a 25 to 50% reduction in baseline IOP without treatment, depending on the level of PIO, stages, age, presence of risk factors, rate of progression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eIndividualized and adjusted during the disease\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCentral corneal thickness (CCT) correction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIs indicated as part of the evaluation of the patient with suspected glaucoma or ocular hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGonioscopy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes. Anterior segment-optical coherence tomography should not serve as a replacement for gonioscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes.\u003c/p\u003e \u003cp\u003eOCT-A can more precisely evaluate iris trabecular contact\u003c/p\u003e \u003cp\u003e(ITC) in 360\u0026deg; compared with gonioscopy.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCannot be replaced by automated imaging\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes, static and dynamic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eIf not available, use OCT or Van Herick.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes. Use UBM exceptionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eIf impossible, choose Van Herick\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes, static and dynamic\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStandard Automated Perimetry (SAP)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIs a fundamental test for detecting visual field loss and for monitoring the rate of visual field change over time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA personalized testing strategy is advisable. This tailored approach ensures that each patient receives optimal care tailored to their specific condition\u003c/p\u003e \u003cp\u003eFactors such as disease stage, patient\u0026rsquo;s age, and current progression status should\u003c/p\u003e \u003cp\u003eguide the frequency of VF testing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUse the same instrument and protocol for follow-up. 2\u0026ndash;6 VF are needed to confirm progression. In advanced glaucoma monitor progression with central 10-degree VF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u0026ndash;6 Visual Field (VF) during the first 2 years, except patients with newly discovered OHT. Adapt the stimulus intensity and size according to the stage of glaucoma.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMinimum of 5 VF to determine progression.\u003c/p\u003e \u003cp\u003eNewly diagnosed glaucoma: measure as frequently as possible during the first 2 years.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eEstablish a baseline and severity of impairment at diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3 times per year during the first 2 years in newly diagnosed patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eRepeat the same strategy that showed a new glaucomatous defect to confirm VF damage progression.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eMinimum of 6 VF in the first 2 years of diagnosis to calculate rate and progression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eChange stimulus size and strategy in advanced disease\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOCT for diagnosis and follow-up\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes. Is useful for documenting the status and progression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOCT is a complementary tool rather than a replacement for a\u003c/p\u003e \u003cp\u003ecomprehensive clinical evaluation.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDo not diagnose or assess progression based on OCT alone. Examinations with different devices are not comparable.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRepeated examinations may show false positive progression. Floor effect in advanced glaucoma complicates assessment.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSuitable for early stages. Not recommended in advanced glaucoma (floor effect)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eUseful for baseline documentation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eDon't diagnose solely on OCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eManagement\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaser trabeculoplasty as first line treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo:\u003c/p\u003e \u003cp\u003eIt is used as an alternative treatment for patients who cannot achieve target IOP using drug therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNo:\u003c/p\u003e \u003cp\u003eIf bad adherence to pharmacological treatment is expected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNo:\u003c/p\u003e \u003cp\u003eIf bad pharmacological treatment adherence is expected. Don't associate with pharmacological treatment in patients with uncontrolled glaucoma.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProstaglandin analogues (PGA) as first-line drug\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther considerations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatients prescribed topical IOP lowering therapy may experience decreased tear film stability and elevated tear osmolarity and should be evaluated for ocular surface disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNew medications and classes of drugs have been developed recently (selective EP2 receptor agonist and Rho kinase inhibitors), broadening our treatment options\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBeta blocker can be chosen as first line treatment. Fixed combination of PGA and beta blocker reduce IOP more than other combinations.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFor good adherence, a fixed combination is usually chosen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDrug therapy is the first -line treatment for primary open-angle glaucoma.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDo not offer treatment to people with suspected chronic open angle glaucoma (COAG) and IOP less than 24 mmHg unless they are at risk of visual impairment within their lifetime. Advise people to continue regular visits to their primary eye care professional.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFixed combination is preferable to multiple drugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eStart treatment with two drugs in patients with high initial IOP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eFixed combinations are not recommended for initial treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eIn people with open-angle glaucoma, initial treatment with beta-blockers is recommended if prostaglandin analogues cannot be used\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eFixed combinations provide improved long-term adherence compared with non-fixed components\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaser trabeculoplasty or Surgery indication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedical therapy failure in achieving optimal IOP control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIf insufficient response, intolerance to treatment or progression, despite lowered IOP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIf more than 3 drugs are required to achieve target IOP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWhen multiple medications are required\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAfter treatment with medicines from 2 therapeutic classes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eWhen insufficiently controlled with two or three agents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eConsider if there is no response to medical treatment, or if there is progression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eIf more than two medications are required to achieve target IOP\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSurgery\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrabeculectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIs therefore a long-term management option for IOP control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThe procedure is conventionally considered the gold standard of penetrating surgery\u003c/p\u003e \u003cp\u003eto create a subconjunctival bleb without the need of an implant, resulting in a cost-effective\u003c/p\u003e \u003cp\u003eapproach to the surgical treatment of glaucoma.\u003c/p\u003e \u003cp\u003eIs the most performed glaucoma filtering surgery.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eComplication\u0026rsquo;s area more frequent than in non-penetrating surgeries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGold standard\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInitial treatment for patients with inadequate control of IOP by drug therapy or laser therapy or for severe cases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOffer people with advanced chronic open angle glaucoma (COAG), glaucoma surgery with pharmacological augmentation (Mitomycin C - MMC) as indicated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eWhen other forms of therapy have failed to control the disease or are not suitable; and target pressure is unlikely to be achievable with topical medications and/or laser.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAdults with primary open angle glaucoma (POAG) that do not meet target IOP despite maximum tolerated pharmacological/laser treatment, are not suitable for pharmacological/laser treatment, or present advanced glaucoma damage at diagnosis.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eIndicated when medications and appropriate laser therapy are insufficient to control disease; can be considered as initial therapy in selected cases.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eIn severe glaucoma and in cases with a high risk of progression despite optimal medical treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePrimary surgery of choice in primary open angle glaucoma (POAG)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCombined trabeculectomy with cataract surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBetter IOP lowering than cataract surgery alone, but lower success rate than filtering surgery alone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWeakly recommended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eIOP reduction is more than phacoemulsification alone. Success rate is less than filtration surgery alone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNot as effective as glaucoma surgery alone in lowering IOP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eSignificantly lower mean IOP than phacoemulsification alone\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMIGS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral information about characteristics. Mention Trabectome surgery used in combination with cataract surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOffer indications for use, recommendations enhance the success of implantation and recommendations postoperative management for trabecular meshwork MIGS (stents and procedures).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBrief comment about MIGS.\u003c/p\u003e \u003cp\u003eNo evidence of the efficacy compared to traditional glaucoma surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGeneral information about characteristics, classification, and indications.\u003c/p\u003e \u003cp\u003eSuitable in early or moderate glaucoma. Not sufficient information on long-term effects and safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eProcedure should be performed by a surgeon with sufficient experience in anterior chamber angle surgery. Mentions: EX-PRESS, ab interno trabeculotomy (with metal hook, nylon thread or, trabectome) and iStent.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eA list of available techniques.\u003c/p\u003e \u003cp\u003eMild to moderate glaucoma. It is possible to combine it with phacoemulsification. Doesn't precise specific techniques.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eDescription list of techniques. Some are only FDA approved to be performed concurrently with phacoemulsification.\u003c/p\u003e \u003cp\u003eLess effective in lowering IOP than trabeculectomy and GDD. More favorable safety profile in the short term. Mentions: Trabectome, KDB, GATT with iTrack or suture, ABiC, iStent and iStent inject, Hydrus microstent, Xen gel stent.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eLack of descriptions and recommendations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eNot recommended\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-penetrating deep sclerectomy (NPDS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-penetrating glaucoma surgery (NPGS) reduces IOP less effectively\u003c/p\u003e \u003cp\u003ethan penetrating surgery, but with lower complication\u003c/p\u003e \u003cp\u003erates.\u003c/p\u003e \u003cp\u003eNPGS may reduce the hypotony risks of trabeculectomy in higher-\u003c/p\u003e \u003cp\u003erisk patients, e.g., high myopes, younger patients, previous\u003c/p\u003e \u003cp\u003evitrectomy, eye-rubbers.\u003c/p\u003e \u003cp\u003eSurgeon preference based on training and experience determines the preferred procedure (NPGS versus trabeculectomy)\u003c/p\u003e \u003cp\u003efor the particular patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBrief comment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBrief comment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBrief comment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eDescription of technique and brief comment about Deep sclerectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eDescription of technique and offers recommendations (1 general and 4 specific)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eBrief comment\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlaucoma drainage devices (GDD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBaerveldt GDDs resulted in greater IOP reduction but more early and serious complications than was encountered with patients receiving Ahmed valves\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndications: previous failed trabeculectomy with antimetabolites, insufficient conjunctiva due to scarring, complicated and refractory glaucomas.\u003c/p\u003e \u003cp\u003eNon-valved drainage devices result in greater postoperative hypotony than valved devices\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigher success rate than trabeculectomy in eyes with previous intraocular surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFirst-line surgical procedure in some cases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePatients with unsuccessful trabeculectomy with concomitant use of antimetabolites, severe conjunctival scarring because of previous surgery, those who are unlikely to achieve successful trabeculectomy or technically cannot undergo other filtration procedures. Less effective in lowering IOP than trabeculectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePatients with risk factors for a poor result of trabeculectomy with antifibrotics. Potential role as a primary surgical procedure in selected cases.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ePatients who do not meet target IOP or evidence a progression in visual field damage despite maximum tolerated pharmacological treatment and trabeculectomy, or when trabeculectomy has a high failure rate.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eIndicated when trabeculectomy has failed to control IOP or is deemed unlikely to succeed. Use patch allografts of sclera, cornea, or pericardium to prevent tube erosion.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003ePatients that have not controlled IOP despite pharmacological treatment, or when filtering surgery has failed. GDDs are not the first choice of surgical treatment in na\u0026iuml;ve patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePatients with high risk of failure from augmented trabeculectomy\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLens extraction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFor patients with POAG results in a modest IOP decrease (13%), reduced medication requirement (12%). Some patients (up to 26%), however, experience worse IOP control and may require additional medications, laser surgery or both\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThere is insufficient evidence to support that IOP reduction from cataract surgery\u003c/p\u003e \u003cp\u003ecan protect against VF deterioration.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMight impair the filtration of a previous glaucoma surgery. The risk is lower if there is a time gap of over 12 months between surgeries.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eConsider early cataract surgery in patients with glaucoma.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eCataract surgery alone as an intervention to control glaucoma is not recommended. Performed after trabeculectomy can affect the IOP control.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eMultifocal intraocular lenses may have adverse effects on contrast sensitivity and visual field performance in patients with glaucoma.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eThe risk of bleb failure is reduced if lens extraction is performed\u0026thinsp;\u0026gt;\u0026thinsp;6 months post-trabeculectomy.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCyclodestructive procedures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatients treated with endocyclophotocoagulation via the pars plana had lower IOPs, needed fewer glaucoma medications, and had a higher success than patients similarly treated via the limbus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBoth forms of diode lasers ( micropulse and standard) are effective forms of trans-scleral cyclophotocoagulation of ciliary body ablation. MicroPulse is thought to be safer, but less efficacious in terms of IOP lowering compared with standard cyclodiode. The technique chosen is based on surgeon preference and equipment availability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEffective and safe in difficult-to-treat glaucoma. Repeated treatments are often required.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWhen filtering surgery has not worked/is not effective enough or not feasible and in painful blind eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRefractory cases in which other treatments are ineffective because it can cause vision threatening complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOffer cyclodiode laser treatment to people with chronic open angle glaucoma (COAG) (including advanced COAG) who prefer not to have glaucoma surgery or whom glaucoma surgery is not suitable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eIndicated when filtration surgery or GDD are likely to fail/have failed/are not feasible; and in refractory glaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAdults with primary open angle glaucoma (POAG) that don't meet target IOP despite treatment, patients that cannot have glaucoma drainage devices (GDD) implanted, and in painful blind eye\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEyes with limited visual potential or that are otherwise poor candidates for incisional ocular surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eIndicated in painful blind eyes or eyes with poor vision, failed multiple filtering surgeries. May be performed in sighted eyes when the benefits outweigh the risks for incisional surgery.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOther issues\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient education and adherence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRecommended.\u003c/p\u003e \u003cp\u003eEye doctors should be persistent in providing education and training to improve adherence/compliance with recommended therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecommended.\u003c/p\u003e \u003cp\u003eAdherence can be improved by identifying the barriers and addressing them strategically\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIt is unclear whether patient education improves compliance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRecommended. Glaucoma schools create affinity and exchange of experience between patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRecommended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRecommended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eRecommended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eRecommended. Peer-support groups or counseling are helpful to some patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eRecommended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eRecommended\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePregnancy and breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacological treatment of POAG should be used with caution during pregnancy and lactation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePresent or possible, renders all interventions potentially hazardous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDiscuss with the doctor that is treating the pregnancy whether to star treatment or to monitor without treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDrug therapy for glaucoma should be discontinued during pregnancy, childbirth, and lactation. Laser therapy or surgery should be considered if IOP control worsens upon discontinuation of the drug. There are no glaucoma medications for which safety has been established in pregnant women, fetuses, or nursing mothers.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSpecific consideration in terms of discussions about management and pharmacological treatment.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eTemporary treatment discontinuation can be considered. No IOP-lowering medications have been labeled for use during pregnancy and/or breastfeeding. Systemic absorption should be reduced by punctal occlusion and eyelid closure. During breastfeeding, PGAs, carbonic anhydrase inhibitors and beta-blockers may be acceptable.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eThe American Academy of Pediatrics has approved the use of carbonic anhydrase inhibitors during lactation. Brimonidine can cause apnea in infants, toddlers, and children; therefore, is not recommended to be used in mothers who are breastfeeding.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eVaginal delivery is not contraindicated and must only be evaluated in cases of severe or advanced glaucoma.\u003c/p\u003e \u003cp\u003eThe ideal for newborn child, who is breastfed, is that de mother can control herself without medical treatment because all drugs can pass through the milk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eTopical beta-blockers can be the first-line medications when considering medical treatment of glaucoma in pregnancy.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eNC: Not covered\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eAOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline NICE: National Institute for Health and Care Excellence\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eEGS: European Glaucoma Society IETSI: Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003ePPP: Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eMethodological Quality\u003c/h2\u003e \u003cp\u003eGlaucoma CPG has evolved with high quality CPG, unlike other diseases like retinal vein occlusion(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Four CPG(AOA,NICE,IETSI and SNSG) reached the minimum suggested for a high-quality CPG(at least 3/6 domains\u0026thinsp;\u0026gt;\u0026thinsp;60% including domain 3), and 2(EGS-5-TGG and MaHTAS) for moderate-quality CPG(\u0026ge;\u0026thinsp;3 domains score\u0026thinsp;\u0026gt;\u0026thinsp;60%, except Domain 3). EGS-5-TGG is the most used CPG in Europe, with a high score in clarity of presentation(88.9%), however it had a low score for \u0026ldquo;Rigour of development\u0026rdquo;. Including a diverse representation of clinical, scientific, and methodological experts\u0026rdquo;(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) leads to a well-developed CPG. APGG, EGS-5-TGG and MaHTAS had low scores for \u0026ldquo;Rigour of development\u0026rdquo; despite including methodological experts, because of the absence of reporting the development process or making it available online, as other CPGs have done. However, they received high scores for the \u0026ldquo;Clarity of Presentation\u0026rdquo; domain. IETSI had the support of methodological experts, achieving high methodological scores with an adequate reporting, but its clinical recommendations are lowly valid.\u003c/p\u003e \u003cp\u003eIn guideline development group(GDG), clinical experts should \u0026ldquo;contextualize evidence, extrapolate evidence from indirect sources and interpret low-quality evidence\u0026rdquo;(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e), strengthening the credibility of the CPG \u0026ldquo;by acknowledging that the final document is based on both an exhaustive evaluation of the published literature(\u0026ldquo;evidence\u0026rdquo;) and the wealth of experience possessed by expert members\u0026rdquo;(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), an issue not achieved by IETSI-CPG.\u003c/p\u003e \u003cp\u003eA CPG ought to provide \u0026ldquo;a clear explanation of how the experts were chosen, how they reached a consensus, and which issues the experts were tasked with addressing\u0026rdquo;(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOu et al.(2011)(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) appraised 3 CPG using AGREE(first version): Preferred-Practice-Pattern \u0026iquest;-in-Primary-Open-Angle-Glaucoma(2005), SEAGIG\u0026rsquo;s Asia-Pacific-Glaucoma-Guidelines(2003\u0026ndash;2004), and EGS-Terminology-and-Guidelines-for-Glaucoma 2nd -edition(2003). They reported that on domain 3-\u0026ldquo;Rigour of development\u0026rdquo;, scores were close to 60%(American-Academy-of-Ophthalmology(AAO) 67%, EGS 63%, and SEAGIG 58%), with high scores in domain 4-\u0026ldquo;Clarity of presentation\u0026rdquo;(AAO 85%, EGS 79%, and SEAGIG 88%). The AGREE-I(first version), did not include \u0026ldquo;strengths and limitations of the body of evidence\u0026rdquo;(Item 9 in AGREE-II), an important issue in CPG development that could decrease the scores for domain 3. Several CPG assessed in our study failed to report the body of evidence properly, including Evidence-to-Decision frameworks(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e) or reporting GRADE tables(36), as NICE and IETSI did.\u003c/p\u003e \u003cp\u003eWu et al.(2015)(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) evaluated the methodological quality of 3 CPG for OAG using AGREE II: American-Academy-of-Ophthalmology(AAO)-2010, Canadian-Ophthalmological-Society(COS)-2009, and National-Institute-for-Health-and-Care-Excellence(NICE)-2009. They reported that in domain 3-\u0026ldquo;Rigour of development\u0026rdquo;, scores were different(AAO 63%, COS 72% and NICE 92%). Also, clarity of presentation scored high (AAO 78%, COS 96%, NICE 97%), with NICE having the best scores over the other CPG evaluated, but all \u0026ldquo;failed to describe specific roles of panel members and/or delineate the involvement of patient representatives\u0026rdquo;, and \u0026ldquo;external review processes were unclear\u0026rdquo;. The description of roles of GDG and including patient representatives is important, considering that glaucoma is a chronic disease with several patient\u0026rsquo;s organizations.\u003c/p\u003e \u003cp\u003eTo improve CPG, GDG should include patients or patient representatives in CPG development; and \u0026ldquo;ensure that patients, patient organizations, and interested members of the public have an opportunity to review the CPG and describe how their comments were addressed\u0026rdquo;(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Only 4 CPG assessed in our study(AOA, FCCG, NICE and SNSG) considered patient representatives or included the views and preferences of the target population. Most CPG include patients in two steps \u0026ldquo;identifying the question\u0026rdquo; and \u0026ldquo;reviewing the draft guideline\u0026rdquo;, usually using a single method (e.g., group or individual contributions, surveys or Delphi)(\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUrrego and \u0026Ntilde;ustes (2019)(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) assessed 4 CPG for OAG in Colombia(Sociedad-Colombiana-de-Oftalmolog\u0026iacute;a 2010), M\u0026eacute;xico (Centro-Nacional-de-Excelencia-Tecnol\u0026oacute;gica en Salud 2016), Chile-(Ministerio-de-Salud-2013) and Spain(SNSG). They reported that 2 CPG scored high in domain 3-\u0026ldquo;Rigour of Development\u0026rdquo;(Mexico 83.3% and SNSG 85.4%) and all CPG scored high in domain 4-\u0026ldquo;Clarity of presentation\u0026rdquo;(mean 90.27%). SNSG scored high scores in our assessment(scores\u0026thinsp;\u0026gt;\u0026thinsp;60% in all domains), with the lowest score in Applicability and Rigour of the development, because of its publication date and search details.\u003c/p\u003e \u003cp\u003eAn update of the SNSG-CPG is available(\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://portal.guiasalud.es/egpc/glaucoma-presentacion/\u003c/span\u003e\u003cspan address=\"https://portal.guiasalud.es/egpc/glaucoma-presentacion/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) and introduce a note for readers:\u0026ldquo;More than 5 years have passed since the publication and its update is pending. The recommendations it contains must be considered with caution considering that their validity is pending evaluation\u0026rdquo;. CPGs become outdated after 3 years(\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e), considering that their search strategy was updated before the publication of the CPG(using Re-run search or database alerts(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e)). Most of the CPG assessed in our study did not perform the last process. Not include a pre-publication update or an evidence gap(time difference between search and publication dates) is frequent in CPG for OAG or MIGS procedures(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWu et al.(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e) appraised the quality of clinical practice guidelines for glaucoma suspects, and its definition, including CPG like EGS-5-TGG, NICE, and MaHTAS. They reported that NICE and MaHTAS scored high in domain 3-\u0026ldquo;Rigour of development\u0026rdquo;(NICE 91%, MaHTAS 84%, and EGS-5-TGG 50%); and they scored high in domain 4-\u0026ldquo;Clarity of presentation\u0026rdquo;(NICE 92%, MaHTAS 89%, and EGS-5-TGG 89%). EGS-5-TGG was the only with 0% in \u0026ldquo;Editorial Independence\u0026rdquo;, similar to our scores for EGS-5-TGG and NSG. It is crucial to consider the importance of reporting Conflict-of-Interest(COI) in CPG since they are often not disclosed(\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e), or inadequately divulged(payments not reported) (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). In critical appraisal, a complete assessment should be done(\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e), especially when assessing CPG, where available tools for report of quality(RIGHT checklist, iCAHE Guideline Quality Checklist), adherence to Trustworthy Standards(NEATS), or development of quality(AGREE-II), recommends the reporting of COI(\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur scores are similar to what reported Wu et al. for these guidelines, however, Wu et al. scored higher for MaHTAS and EGS-5-TGG, assessed by 2 authors. In our study, 5 appraisers(3 ophthalmologist and 2 ophthalmologists with experience in glaucoma) appraised all the CPG, and 5 authors had previous experience in CPG appraisal(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan additionalcitationids=\"CR46\" citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Agree-II recommends at least 2 appraisers and preferably 4, because a higher number of appraisers increase the reliability(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). High quality CPG may not necessarily have recommendations highly valid, implementable or clinical applicable, so a CPG should be evaluated for its methodology, content, and the use of its recommendations in clinical practice(\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). For the most comprehensive evaluation of ophthalmology CPGs, it is ideal to have ophthalmologists with expertise in evidence-based medicine, critical appraisal and guideline methodology, as they can appraise both the methodological process and the relevance of the content. EGS-5-TGG had a low score in domain 3, however they included easy-to-apply flowcharts, checklists, algorithms and summaries, becoming one of the most useful CPG for its use in daily clinical practice(recommended with modifications). IETSI CPG had a high score in domain 3 but with recommendations were lowly valid for ophthalmologists.\u003c/p\u003e \u003cp\u003eQureshi et al.(2021)(\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) identified systematic reviews(SR) of interventions for glaucoma and assessed their reliability. They reported that only 49/129-SR are reliable, and most reviews addressed OAG and OHT. Only 17-SR, were reliable for medical interventions and 16-SR for surgical and postoperative interventions; however, there was an uncertainty about the effectiveness of combined cataract surgery. Only 11-SR were reliable for laser and perioperative interventions, concluding that SLT is effective as the first line for POAG and selective ALT have similar efficacy to reduce IOP. Regarding surgical devices 5-SR were reliable, however there was uncertainty about MIGS effectiveness, and its use in combined surgery with cataract or MIGS alone. This SR included studies until August-2019, so it did not include results from LIGHT(Laser-in-Glaucoma-and-Ocular-Hypertension) or SALT(Steroids-After-Laser-Trabeculoplasty) trials.\u003c/p\u003e \u003cp\u003eIn the last years, the total number of recommendations in PPP has decreased, especially in glaucoma, however, high level of evidence recommendations has increased(\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e). When making recommendations, GDG should include the impact on equity of recommendations, and promote equitable practices in older people, with limited economic resources, living in rural contexts, with poor access to health services, from racial and ethnic minorities, or in cases of cognitive or physical disability. Only NICE, IETSI and POAG-PPP-2020 addressed these issues.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eGuideline clinical recommendation meta-synthesis\u003c/h2\u003e \u003cp\u003eSeveral studies have reported several risk factors associated with glaucoma; however, recent evidence has reported obstructive sleep apnea as a risk factor(Odds Ratio 3.66)(\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). Other factors like smoking(moderate to heavy smoking) have shown conflicting evidence, showing an association with glaucoma progression(vessel density loss) (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e) versus no association(\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e), or alcohol(implicated in OAG risk, however mediating or confounding factors can be present)(\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e). Rovelt et al. reported that several factors like Obstructive Sleep Apnea and Diabetes, are the risk factors assessed across different study designs, unlike other risk factors(\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMost of the CPG do not recommend or addresses screening; however, APPG, PPP, SNSG and MATHAS recommend the screening in patients at high risk. The-United-States-Preventives Services-Task-Force(USPSTF), The United-Kingdom\u0026rsquo;s National-Screening-Committee, the Pan-American-Association-of-Ophthalmology, and The International-Council-of-Ophthalmology\u0026rsquo;s 2015 Glaucoma-Eye-Care-Task-Force neither recommend screening(\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e). An evidence report published in 2022 by the USPSTF regarding Screening for Glaucoma in Adults reported limited direct evidence on glaucoma screening, showing no association with benefits(\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eActually, there is controversy regarding the role of lens extraction(early cataract surgery recommended by NSG or not recommended as a surgery alone by EGS-5-TGG). Armstrong et al. reported that in patients with POAG, cataract surgery alone decreased IOP and the number of antiglaucoma medication(NAM) (\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e). IOP reduction was 11.9%, 14.4% and 15.4%, for 1 month, 1 and 2 years postoperatively, respectively(\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e). A systematic review of randomized controlled trials reported that cataract surgery in patients with OAG had a decrease on IOP following surgery and a reduced dependency on glaucoma medications(\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e). Pasquali et al. reported a significant IOP reduction in patients with OAG after cataract surgery(6, 12 and 24 months)(\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e). Benekos et al reported that cataract surgery leads to a reduction of 3.77 mm-Hg (95%-CI:\u0026minus;5.55 to \u0026minus;\u0026thinsp;1.99) at 12 months(\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe CPG evaluated the effectiveness of combined cataract and glaucoma surgery, and found that combined surgery with trabeculectomy may lead to a greater decrease in IOP but a lower success rate. A Cochrane review assessed the relative effectiveness and safety of combined surgery versus cataract surgery, and reported that there is low-quality evidence that combined surgery has better IOP control compared with cataract surgery alone(\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e). Also, there was uncertainty regarding the complications of the surgery, and the quality of the evidence was very low(several types of glaucoma surgery) and poor(reporting of the outcomes)(\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMost of the CPG recommended SLT, except JGSG, IETSI an SNSG, however, the last was the only CPG published before the first report of LIGHT-trial results. LIGHT changed the paradigm of the primary treatment for glaucoma and positioned the SLT as the primary treatment in patients with OAG. Zhou et al. reported on a Meta-Analysis published in 2021, that several types of lasers trabeculoplasty are equally effective for decreasing IOP compared with medical therapy(\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e). 180-degree-SLT was slightly more effective than ALT reducing NAM, however there was no significant difference between 180\u0026deg; and 360\u0026deg; SLT at six months(\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRolim-de-Moura et al. reported on a Cochrane systematic review published in 2022, that Laser trabeculoplasty is better than antiglaucoma medication(AM) in terms of progression of open-angle glaucoma(visual field loss) and may be like modern eye drops in controlling eye pressure at a lower cost, with no serious unwanted effects(\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e). Gazzard et al. published in 2023 the 6-years results of LIGHT-trial, and reported that SLT provides long-term control in patients with OAG vs antiglaucoma medications(AM), with a reduced need for incisional glaucoma and cataract surgery(\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSLT is an effective long-term option to treat OAG, equivalent to ALT based on level I evidence, according to an HTA performed by the AAO in January-2024(\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e). SLT can be used either as primary treatment, as a replacement for AM, or as an additional intervention in patients with AM(\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e). Zhu et al reported a greater IOP reduction at one month and at one year with 360\u0026deg;-SLT compared with 180\u0026deg;, however, there was not a significant difference at 2 years(\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e). Chavez et al. reported a higher proportion of patients achieving\u0026thinsp;\u0026ge;\u0026thinsp;20% IOP reduction in medical treatment group(compared with SLT)(\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e). However, SLT had similar IOP control, with similar rate of eyes at target IOP, quality of life, visual field, and reduced rates of glaucoma surgeries, antiglaucoma medications, and ocular adverse effects(\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegarding MIGS, Michaelov et al.(2018) (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) assessed the methodological quality of 14-CPGs and recommendations for MIGS procedures. They reported several CPG scored high for Rigour of development(POAG-PPP 2016 94.4%, EGS 2014 68%, NICE 2009 99.3%). Also, only 3/11 CPGs mentioned MIGS as an option for surgical management of glaucoma(the APGG-2016, the POAG-PPP-2016, and the EGS-2014).\u003c/p\u003e \u003cp\u003eOn a recently published scoping review performed by our team, we assessed recommendations addressing MIGS in 13 OAG-CPG or MIGS procedures CPG like the NICE-Interventional-Procedure-Guideline and the EGS-SI(European-Glaucoma-Society-A-guide-on-surgical-innovation-for-glaucoma). We found that the assessed CPGs have not adequately addressed MIGS recommendations in terms of updated evidence, available procedures, and recommendations(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). APGG was published in May 2024, so it was not included in this assessment; however, they included a chapter describing available procedures and techniques(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMost of CPG recommend trabeculectomy as gold standard, however this statement could change in future years. Since introducing MIGS, trabeculectomy became less used or is indicated when MIGS fails. Zaifar et al. reported that when comparing cataract\u0026thinsp;+\u0026thinsp;MIGS vs cataract\u0026thinsp;+\u0026thinsp;trabeculectomy, both combined surgeries have similar outcomes, but the first has less severe complications (e.g. hypotony, maculopathy, and choroidal effusion)(\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCPG recommends Glaucoma drainage devices(GDD) in eyes with risk factors for a poor result of trabeculectomy or in cases with previous intraocular surgery. The Primary-Tube-Versus-Trabeculectomy study was a multicenter randomized clinical trial comparing the safety and efficacy of tube shunt surgery and trabeculectomy with mitomycin-C(MMC) in eyes without previous ocular surgery. They reported similar IOP reduction for both procedures after 5 years, however; the NAM was lower for trabeculectomy(\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e). A recently published Health-Technology-Assessment(HTA) from the AAO(February-2024) assessed the \u0026ldquo;efficacy and safety of the use of aqueous shunts with extraocular reservoir for the management of adult OAG\u0026rdquo;, and reported that valved/non-valved devices are effective at lower IOP in eyes with and without prior incisional surgery, supported by strong evidence(\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e). Also, they reported that evidence to show superiority of tubes over trabeculectomy as a primary glaucoma surgery is lacking(\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFew CPG addressed non-penetrating-deep-sclerectomy(NPDS). NPDS is a worldwide procedure that prevents the sudden hypotony related to penetrating surgery and lets the filtration of aqueous humour through trabeculo-Descemet membrane. NPDS reports showed a marginally lower effect over IOP compared with trabeculectomy, but same efficacy, and lower risks of complication(\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e). One issue with NPDS is that a peak emerges some months after the surgery, requiring a goniopuncture to be performed. Slagle et al. reported that a \u0026ldquo;3 month cut-off was associated with better IOP control and less adverse events than early laser goniopuncture\u0026rdquo;(\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNPDS can be performed alone or in combination with cataract surgery; with no devices or using a Nonabsorbable-Uveoscleral-Implant(Esnoper-Clip)(\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e). When comparing NPDS alone or in combination with cataract surgery, efficacy is similar, and the last achieves excellent IOP control(\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e, \u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e). When comparing penetrating and NPDS, the last had a better safety profile(Best-Corrected-Visual-Acuity recovery, complication rates and post-operative interventions)(\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePatients\u0026rsquo; adherence to glaucoma medications is a relevant issue. Most of the CPG recommend patient education and adherence, which includes benefits in side effects of treatment, proper instillation technique of eye drop and compliance and continuity to treatment; however, FGCC reports an unclear effect of education over compliance. EGS assessed the interventions that can improve adherence to medical treatment, and reported that \u0026ldquo;simplified regime, education, effective communication, and alarms/messages\u0026rdquo; have very low level of evidence, with a weak strength of recommendation.\u003c/p\u003e \u003cp\u003eCPG makes recommendations for future research, addressing epidemiological, clinical, diagnostic, or treatment issues. Only AOA, NICE, JGSG, IETSI, and SNSG guidelines suggest topics with insufficient evidence that researchers can address nearby as clinical questions for better decision-making.\u003c/p\u003e \u003cp\u003eAzuara et al. reported EGS research priorities for glaucoma care and includes: stop sight loss/stopping progression of glaucoma, improved detection of worsening glaucoma/better tools to detect progression, better surgical or laser treatments including improved MIGS or better evidence for MIGS, and treatments with fewer side effects(\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFinally, glaucoma is an ophthalmological condition, continuously evolving with recent developments, most of them with the goal of achieve relevant outcomes. Results do not show which CPG is better, but we can report that NICE, IETSI and SNSG CPGs for the diagnosis and management of OAG have a high methodological quality, appraised with AGREE-II. NICE, EGS-5-TGG, IETSI and SNSG have high scores in applicability.\u003c/p\u003e \u003cp\u003eFinally, NICE, IETSI and SNSG CPGs for the diagnosis and management of OAG have a high methodological quality, appraised with AGREE-II. NICE, EGS-5-TGG, IETSI and SNSG have high scores in applicability. In the meta-synthesis, the CPGs show similar recommendations, but there is variability in the indications for selective laser trabeculoplasty and MIGS.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCPG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eClinical Practice Guidelines\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHTA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealth technology assessment\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOAG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOpen Angle Glaucoma\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePOAG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrimary Open Angle Glaucoma\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAGREE-II\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAppraisal of Guidelines for Research and Evaluation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMIGS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMinimally invasive glaucoma surgery\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIOP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIntraocular pressure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAOA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAmerican Optometric Association\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAPGG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAsia Pacific Glaucoma Guideline\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFCCG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFinnish Current Care Guideline for diagnostics, treatment and follow-up of primary open-angle glaucoma, normal-tension glaucoma and pseudoexfoliative glaucoma\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNSG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNordic and Swedish guidelines for the management of open-angle glaucoma\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eJGSG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Japan Glaucoma Society guidelines for glaucoma \u0026minus;\u0026thinsp;5th edition\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNICE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Institute for Health and Care Excellence\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEGS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEuropean Glaucoma Society\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEGS-5-TGG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTerminology and Guidelines for Glaucoma (5th edition)\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIETSI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInstituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n \u0026ndash; EsSalud, Per\u0026uacute;\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePPP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePreferred Practice Pattern\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePOAG-PPP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrimary Open-Angle Glaucoma Preferred Practice Pattern\u0026reg;\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSNSG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSistema Nacional de Salud Guideline\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMaHTAS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMalaysian Health Technology Assessment Section\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGDG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGuideline Development Group\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGRADE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGrading of Recommendations, Assessment, Development, and Evaluations\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCorneal Central Thickness\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSAP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStandard Automated Perimetry\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOptical Coherence Tomography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePGA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eProstaglandin Analogues\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNPDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNon-Penetrating Deep Sclerectomy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGDD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGlaucoma Drainage Devices\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOHT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOcular Hypertension\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eVF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eVisual Field\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOAG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eChronic Open Angle Glaucoma\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eKDB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eKahook Dual Blade\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGATT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGonioscopy Assisted Transluminal Trabeculotomy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eABiC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAb-interno Canaloplasty\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSEAGIG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSouth East Asia Glaucoma Interest Group\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAAO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAmerican Academy of Ophthalmology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCanadian Ophthalmological Society\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSLT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSelective Laser Trabeculoplasty\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eALT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eArgon laser trabeculoplasty\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLIGHT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLaser in Glaucoma and Ocular Hypertension\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSALT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSteroids after Laser Trabeculoplasty\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNAM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNumber of antiglaucoma medication\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntiglaucoma medication\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflict of interest:\u003c/h2\u003e \u003cp\u003eJGO has received speaker fees of Esteve, Novelty Technology Care and Angelini. JGO has received Travel and meeting support from Esteve, Bausch and Lomb, Thea, Equipsa, Alcon, Zeiss, Angelini, Brudylab, Salvat, and Sifi.\u003c/p\u003e \u003cp\u003eRBE has received Travel and meeting support from Bayer, Salvat, Zeiss, Angelini, Thea, Roche, Alcon, Esteve and AbbVie.\u003c/p\u003e\u003cp\u003eISO have nothing to disclose.\u003c/p\u003e\u003cp\u003eSBU has received travel and meeting support from Thea.\u003c/p\u003e\u003cp\u003eRMB has received meeting support from Lansier, Ophtha and Saval.\u003c/p\u003e\u003cp\u003eCBM has received Travel and meeting support from Bausch and Lomb.\u003c/p\u003e\u003cp\u003eTGO has received speaker fees of Medica del Pacifico.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e \u003ch2\u003eAuthor Contribution Statement\u003c/h2\u003e \u003cp\u003eJGO: Conceptualization, Validation, Formal analysis, Investigation, Data Curation, Writing - Original Draft, Writing - Review \u0026amp; Editing.\u003c/p\u003e \u003cp\u003eRBE: Validation, Formal analysis, Investigation, Data Curation, Writing - Original Draft, Writing - Review \u0026amp; Editing.\u003c/p\u003e \u003cp\u003eISO: Validation, Formal analysis, Investigation, Data Curation, Writing - Review \u0026amp; Editing.\u003c/p\u003e \u003cp\u003eSBU: Validation, Formal analysis, Investigation, Data Curation, Writing - Review \u0026amp; Editing.\u003c/p\u003e \u003cp\u003eRMB: Validation, Formal analysis, Investigation, Data Curation, Writing - Review \u0026amp; Editing.\u003c/p\u003e \u003cp\u003eCBM: Validation, Investigation, Data Curation, Writing - Original Draft, Writing - Review \u0026amp; Editing.\u003c/p\u003e \u003cp\u003eTGO: Conceptualization, Investigation, Writing - Review \u0026amp; Editing.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSupplementary Information\u003c/strong\u003e \u003cp\u003eSupplementary information is available at eye\u0026rsquo;s website\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eSelf-funded.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eEuropean Glaucoma Society. Terminology and Guidelines for Glaucoma. 5th edition. 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGallo Afflitto G, Aiello F, Cesareo M, Nucci C. Primary Open Angle Glaucoma Prevalence in Europe: A Systematic Review and Meta-Analysis. J Glaucoma. 2022;31(10):783\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstitute of Medicine. Clinical practice guidelines we can trust. Washington DC: The National Academies Press; 2011.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrum BE, Rosenberg LF, Gedde SJ, Mansberger SL, Stein JD, Moroi SE, et al. Primary Open-Angle Glaucoma Preferred Practice Pattern(\u0026reg;) Guidelines. Ophthalmology. 2016;123(1):P41-111.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGedde SJ, Vinod K, Wright MM, Muir KW, Lind JT, Chen PP, et al. Primary Open-Angle Glaucoma Preferred Practice Pattern\u0026reg;. Ophthalmology. 2020;128(1):P71-150.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAsia-Pacific Glaucoma Society, editor. Asia Pacific glaucoma guidelines. Third edition. Amsterdam: Kugler Publications; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAsian Pacific Glaucoma Society. Asia Pacific Glaucoma Guidelines. 4th ed. Amsterdam: Kugler Publications; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrouwers MC, Kerkvliet K, Spithoff K, AGREE Next Steps Consortium. The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines. BMJ. 8 de marzo de 2016;i1152.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOu Y, Goldberg I, Migdal C, Lee PP. A Critical Appraisal and Comparison of the Quality and Recommendations of Glaucoma Clinical Practice Guidelines. Ophthalmology. 2011;118(6):1017\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu AM, Wu CM, Young BK, Wu DJ, Chen A, Margo CE, et al. Evaluation of primary open-angle glaucoma clinical practice guidelines. Can J Ophthalmol. 2015;50(3):192\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUrrego Martinez PA, \u0026Ntilde;ustes Malagon PAU. Glaucoma primario de \u0026aacute;ngulo abierto: evaluaci\u0026oacute;n de la calidad de gu\u0026iacute;as de pr\u0026aacute;ctica cl\u0026iacute;nica de Colombia, M\u0026eacute;xico, Chile y Espa\u0026ntilde;a [Trabajo de grado]. Bogot\u0026aacute;: Universidad de La Salle; 2019. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://ciencia.lasalle.edu.co/optometria/369\u003c/span\u003e\u003cspan address=\"https://ciencia.lasalle.edu.co/optometria/369\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMichaelov E, Armstrong JJ, Nguyen M, Instrum B, Lam T, Denstedt J, et al. Assessing the Methodological Quality of Glaucoma Clinical Practice Guidelines and Their Recommendations on Microinvasive Glaucoma Surgery: A Systematic Review. J Glaucoma. 2018;27(2):6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGalvez-Olortegui J, Burgue\u0026ntilde;o-Monta\u0026ntilde;es C, Silva-Ocas I, Bernales-Urbina S, Galvez-Olortegui T. Minimally Invasive Glaucoma Surgery (MIGS) recommendations in Clinical Practice Guidelines for open angle glaucoma and MIGS procedures: A scoping review. Eur J Ophthalmol. 2024; e-pub ahead of print 22 August 2024; doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/1120672124127622\u003c/span\u003e\u003cspan address=\"10.1177/1120672124127622\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLingham G, Thakur S, Safi S, Gordon I, Evans JR, Keel S. A systematic review of clinical practice guidelines for childhood glaucoma. BMJ Open Ophthalmol. 2022;7(1):e000933.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePage MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;29:n71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeel S, Evans JR, Block S, Bourne R, Calonge M, Cheng CY, et al. Strengthening the integration of eye care into the health system: methodology for the development of the WHO package of eye care interventions. BMJ Open Ophthalmol. 2020;5(1):e000533.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJohnston A, Kelly SE, Hsieh SC, Skidmore B, Wells GA. Systematic reviews of clinical practice guidelines: a methodological guide. J Clin Epidemiol. 2019;108:64\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGalvez-Olortegui J, Bouchikh-El Jarroudi R, Silva-Ocas I, Palacios-Herrera H, Cubillas-Martin M, Zavaleta-Mercado M, et al. Systematic review of clinical practice guidelines for the diagnosis and management of retinal vein occlusion. Eye. 2024;38(9):1722\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAGREE Next Steps Consortium. 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Two-year Results After Deep Sclerectomy With Nonabsorbable Uveoscleral Implant (Esnoper-Clip): Surgical Area Analysis Using Anterior Segment Optical Coherence Tomography. J Glaucoma. 2017;26(10):929\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTakmaz T, Akmeşe HE, Onursever N. Comparison of combined phacoemulsification-non-penetrating deep sclerectomy and phacoemulsification-trabeculectomy. Int Eye Sci. 2015;15(11):1851\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBilgin G, Karakurt A, Saricaoglu MS. Combined Non-Penetrating Deep Sclerectomy with Phacoemulsification Versus Non-Penetrating Deep Sclerectomy Alone. Semin Ophthalmol. mayo de 2014;29(3):146\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMerlo Pich FGG, Oliverio L, Gillmann K, Mermoud A. Outcomes of Non-Penetrating versus Penetrating Deep Sclerectomy in Open-Angle Glaucoma. J Glaucoma. 16 de mayo de 2024;\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAzuara-Blanco A, McCorry N, Tatham AJ, Georgoulas S, Founti P, Schweitzer C, et al. European Glaucoma Society research priorities for glaucoma care. Br J Ophthalmol. 2024;108(8):1088\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTabl\u003c/strong\u003e\u003cstrong\u003ee\u0026nbsp;1:\u0026nbsp;Selected CPG for the diagnosis and management of open angle glaucoma.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"1106\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDenomination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTitle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of Publication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrganization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLanguage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eAOA (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eCare of the Patient with Primary Open-Angle Glaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eAmerican Optometric Association (AOA) Evidence-based Optometry Guideline Development Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eAPGG\u0026nbsp;(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eAsia Pacific Glaucoma Guideline\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eAsian Pacific Glaucoma Society\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eFCCG\u0026nbsp;(21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eFinnish Current Care Guideline for diagnostics, treatment and follow-up of primary open-angle glaucoma, normal-tension glaucoma and pseudoexfoliative glaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2024 (\u003cstrong\u003e2023\u003c/strong\u003e****)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eFinnish Medical Society Duodecim, the Finnish Association of Ophthalmologists and the Finnish Glaucoma Society - Finland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish/Finnish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eNSG\u0026nbsp;(23)\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eNordic and Swedish guidelines for the management of open-angle glaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2024 (\u003cstrong\u003e2022\u003c/strong\u003e***)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eSwedish ophthalmological society \u0026ndash; Sweden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish/Swedish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eJGSG\u0026nbsp;(25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eThe Japan Glaucoma Society guidelines for glaucoma - 5th edition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2023 (\u003cstrong\u003e2022*\u003c/strong\u003e*)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eJapan Glaucoma Society \u0026ndash; Japan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eJapanese/English\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eNICE\u0026nbsp;(27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eGlaucoma: diagnosis and management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2022 (\u003cstrong\u003e2017\u003c/strong\u003e*)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eNational Institute for Health and Care Excellence (NICE) \u0026ndash; United Kingdom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eEGS-5-TGG\u0026nbsp;(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eTerminology and Guidelines for Glaucoma (5th edition)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eEuropean Glaucoma Society-Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish/Spanish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eIETSI\u0026nbsp;(28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eGu\u0026iacute;a de Pr\u0026aacute;ctica Cl\u0026iacute;nica para el manejo de Glaucoma de \u0026Aacute;ngulo Abierto\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eInstituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n - EsSalud \u0026ndash; Per\u0026uacute;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eSpanish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003ePOAG-PPP-2020\u0026nbsp;(5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003ePrimary Open-Angle Glaucoma Preferred Practice Pattern\u0026reg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eAmerican Academy of Ophthalmology \u0026ndash; United States of America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eSNSG\u0026nbsp;(29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eGu\u0026iacute;a de Pr\u0026aacute;ctica Cl\u0026iacute;nica sobre Glaucoma de \u0026Aacute;ngulo Abierto\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eMinisterio de Sanidad, Servicios Sociales e Igualdad de Espa\u0026ntilde;a and Ag\u0026egrave;ncia de Qualitat i Avaluaci\u0026oacute; Sanit\u0026agrave;ries de Catalunya - Spain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eSpanish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.2262%;\"\u003e\n \u003cp\u003eMaHTAS\u0026nbsp;(30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9548%;\"\u003e\n \u003cp\u003eManagement of Glaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1312%;\"\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38.19%;\"\u003e\n \u003cp\u003eMalaysian Health Technology Assessment Section\u003c/p\u003e\n \u003cp\u003eMedical Development Division, Ministry of Health - Malaysia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.4977%;\"\u003e\n \u003cp\u003eEnglish\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e**** Published in Finnish in March 2023\u0026nbsp; \u0026nbsp; \u0026nbsp;*** Published in Swedish in September 2022 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;**Published in Japanese in February 2022\u003c/p\u003e\n\u003cp\u003e* Last updated: 26 January 2022\u003c/p\u003e\n\u003cp\u003eAOA: American Optometric Association\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;APGG: Asia Pacific Glaucoma Guidelines \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;FCCG: Finnish Current Care Guideline\u003c/p\u003e\n\u003cp\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline\u0026nbsp; \u0026nbsp;NICE: National Institute for Health and Care Excellence\u003c/p\u003e\n\u003cp\u003eEGS: European Glaucoma Society IETSI:\u0026nbsp;Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/p\u003e\n\u003cp\u003ePPP:\u0026nbsp;Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/p\u003e\n\u003cp\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eTable 2:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eCharacteristics of CPG for the diagnosis and management of open angle glaucoma.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"1068\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubcharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eAOA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eAPGG\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eFCCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNSG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eJGSG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNICE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eEGS-5-TGG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eIETSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003ePOAG-PPP-2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eSNSG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eMaHTAS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGuideline status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNew\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNew\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eNew\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eUpdate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDeveloper organization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eSociety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eSociety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eSociety and PO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003ePO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eSociety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003ePO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eSociety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003ePO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eSociety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003ePO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003ePO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDevelopment group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e9*(25**)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAffiliation details\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpecialty/sub-specialty details\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-physician specialist\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePopulation representative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNR****\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMethodologist\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExternal review\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGeneral features\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScope\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTarget users\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePopulation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEvidence searches\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSearch strategy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of referenced citations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e508\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e707\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e170\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpdate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevious guide\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e2008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNext update\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e2026-2029***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e2024***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e2025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDetailed declaration of conflict of interest\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonitoring and/or auditing criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEvidence and grading of recommendations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eGRADE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eNR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eGRADE\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003eGRADE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eGRADE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eGRADE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eGRADE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eGRADE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eGRADE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical questions in the CPG\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1*****\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNR: Not reported\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;NA: Not applicable. PO: Public Organization\u003c/p\u003e\n\u003cp\u003e*2021 Guideline Update Committee\u0026nbsp;\u0026nbsp;**2017 Guideline Committee members and NGC technical team members\u0026nbsp;***Based on their update plan\u003c/p\u003e\n\u003cp\u003e****Not reported in the Guideline Development Group (GDG), but considered in during the development.\u003c/p\u003e\n\u003cp\u003e*****1 question for the updated version.\u003c/p\u003e\n\u003cp\u003ea: CPG with no free access. Available through Santen Pharmaceuticals, owner of the rights to distribute it.\u003c/p\u003e\n\u003cp\u003eAOA: American Optometric Association\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;APGG: Asia Pacific Glaucoma Guidelines \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;FCCG: Finnish Current Care Guideline\u003c/p\u003e\n\u003cp\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline\u0026nbsp; \u0026nbsp;NICE: National Institute for Health and Care Excellence\u003c/p\u003e\n\u003cp\u003eEGS: European Glaucoma Society IETSI:\u0026nbsp;Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/p\u003e\n\u003cp\u003ePPP:\u0026nbsp;Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/p\u003e\n\u003cp\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Domain s\u003c/strong\u003e\u003cstrong\u003ecores\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"1102\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eDomain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eAOA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eAPGG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFCCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eNSG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eJGSG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003eNICE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eEGS-5-TGG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003eIETSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003ePOAG-PPP-2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eSNSG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eMaHTAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eMEAN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e1:\u0026nbsp;Scope and Purpose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e52.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e32.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e83.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e31.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e37.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e92.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e82.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e72.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e37.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e96.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e77.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e63.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e2:\u0026nbsp;Stakeholder Involvement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e66.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e27.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e41.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e15.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e80.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e66.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e53.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e43.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e88.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e64.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e51.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e3:\u0026nbsp;Rigour of Development\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e63.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e11.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e41.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e5.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e25.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e92.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e30.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e77.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e39.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e75.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e44.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e46.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e4:\u0026nbsp;Clarity of Presentation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e91.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e73.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e60.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e47.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e65.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e97.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e88.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e78.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e42.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e94.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e73.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e73.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e5:\u0026nbsp;Applicability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e31.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e12.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e40.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e29.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e21.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e80.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e56.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e41.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e61.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e63.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e43.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e6:\u0026nbsp;Editorial Independence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e35.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e45.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e55.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e35.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e90.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e58.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e86.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e38.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e47.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eOverall Guideline Assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e3,5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eRecommendation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003eYes, w/o\u0026nbsp;modif.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eYes, w/ modif.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eYes, w/ modif.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eYes, w/ modif.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;AOA: American Optometric Association APGG: Asia Pacific Glaucoma Guidelines FCCG: Finnish Current Care Guideline\u003c/p\u003e\n\u003cp\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline\u0026nbsp; \u0026nbsp;NICE: National Institute for Health and Care Excellence\u003c/p\u003e\n\u003cp\u003eEGS: European Glaucoma Society IETSI:\u0026nbsp;Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/p\u003e\n\u003cp\u003ePPP:\u0026nbsp;Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/p\u003e\n\u003cp\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/p\u003e\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Summary of Appraisers\u0026rsquo; Comments on the Open Angle Glaucoma Clinical Practice Guidelines assessed, organized by AGREE II Domains\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"756\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAGREE II domain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrength\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeaknesses\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1. Scope and Purpose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eThe objective is well defined (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG partially in JGSG, NSG, APGG, AOA).\u003c/li\u003e\n \u003cli\u003eThe health questions are covered (NICE, EGS-5-TGG, IETSI, SNSG, MaHTAS, FCCG, partially in JGSG, AOA).\u003c/li\u003e\n \u003cli\u003ePopulation to whom the guideline is meant to apply is described (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA partially in EGS-5-TGG, FCCG).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eHealth questions are not specifically described (POAG-PPP-2020, JGSG, NSG, APGG).\u003c/li\u003e\n \u003cli\u003eNo description of excluded populations is available (IETSI, POAG-PPP-2020, JGSG, NSG, APGG).\u003c/li\u003e\n \u003cli\u003ePopulation to whom the guideline is meant to apply is not described (JGSG, NSG, APGG).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2. Stakeholder Involvement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eGuideline development group included individuals from relevant professional groups: clinical and methodological (NICE, POAG-PPP-2020, SNSG, MaHTAS, JGSG, AOA, partially in NSG, FCCG).\u003c/li\u003e\n \u003cli\u003eViews and preferences of the target population were addressed (NICE, SNSG, FCCG, AOA, partially in EGS-5-TGG).\u003c/li\u003e\n \u003cli\u003eTarget users were reported (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, APGG, AOA).\u003c/li\u003e\n \u003cli\u003eGuideline development group partially describes the expertise, institution, geographical location, or member\u0026rsquo;s role (EGS-5-TGG, APGG, AOA).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eDoes not include patient representatives (IETSI, NSG, JGSG, APGG).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eThe views and preferences of the target population have not been sought (IETSI, POAG-PPP-2020, MaHTAS, NSG, JGSG, APGG).\u003c/li\u003e\n \u003cli\u003eNo description about discipline/content expertise, institution, or geographical location was reported (POAG-PPP-2020).\u003c/li\u003e\n \u003cli\u003eNo report of target users (FCCG, NSG)\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3. Rigor of development\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eDetails of the strategy used were reported (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA, partially in NSG).\u003c/li\u003e\n \u003cli\u003eThe criteria for selecting the evidence are clearly described (NICE, IETSI, partially in POAG-PPP-2020, SNSG, MaHTAS, JGSG, FCCG, AOA).\u003c/li\u003e\n \u003cli\u003eStrengths and limitations of the body of evidence are clearly described (NICE, IETSI, SNSG, MaHTAS, partially in JGSG, AOA).\u003c/li\u003e\n \u003cli\u003eMethods for formulating the recommendations are described (IETSI, AOA, partially in SNSG, MaHTAS, JGSG and FCCG).\u003c/li\u003e\n \u003cli\u003eThe health benefits, side effects, and risks have been considered in formulating the recommendations (NICE, IETSI, SNSG, JGSG, AOA, partially in APGG).\u003c/li\u003e\n \u003cli\u003eThere is an explicit link between the recommendations and the supporting evidence (NICE, IETSI, SNSG, FCCG, AOA, partially in JGSG, APGG).\u003c/li\u003e\n \u003cli\u003eThe guideline has been externally reviewed by experts prior to its publication (NICE, IETSI, POAG-PPP-2020, SNSG, MaHTAS, FCCG, AOA).\u003c/li\u003e\n \u003cli\u003eA procedure for updating the guideline was provided (IETSI, POAG-PPP-2020, SNSG, MaHTAS, AOA, partially in NICE).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eNo details of the strategy used were reported (JGSG, APGG).\u003c/li\u003e\n \u003cli\u003eDid not carry out systematic searches for costs, outcomes assessment by patients, feasibility, or implementation (IETSI, JGSG, APGG).\u003c/li\u003e\n \u003cli\u003eThe methods for formulating the recommendations are partially described (NICE, FCCG, APGG).\u003c/li\u003e\n \u003cli\u003eStrengths and limitations of the body of evidence, methods for formulating recommendations, are not clearly described (POAG-PPP-2020, JGSG, FCCG, APGG).\u003c/li\u003e\n \u003cli\u003eHealth benefits, side effects, and risks in formulating recommendations, have not been reported (MaHTAS).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eThere is no explicit link between the recommendations and the supporting evidence (MaHTAS, POAG-PPP-2020).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eA procedure for updating the guideline is not provided (EGS-5-TGG, JGSG, APGG).\u003c/li\u003e\n \u003cli\u003eGuideline wasn\u0026rsquo;t externally reviewed (JGSG).\u003c/li\u003e\n \u003cli\u003eMost of the domain items were not reported or free available (EGS-5-TGG, NSG).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGuideline was externally reviewed, but external reviewers\u0026rsquo; comments are not available (EGS-5-TGG, APGG).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4. Clarity of presentation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eRecommendations are specific and unambiguous (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA).\u003c/li\u003e\n \u003cli\u003eThe different options for management of the condition or health issue are clearly presented (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, JGSG, NSG, FCCG, APGG, AOA).\u003c/li\u003e\n \u003cli\u003eKey recommendations are easily identifiable (NICE, EGS-5-TGG, IETSI, POAG-PPP-2020, SNSG, MaHTAS, NSG, APGG, partially FCCG, AOA).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eDoes not include several clinical issues relevant to glaucoma (IETSI).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5. Applicability\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eDescribes facilitators and barriers to its application (IETSI, MaHTAS, NICE, AOA, partially in SNSG, POAG-PPP-2020, NSG, APGG).\u003c/li\u003e\n \u003cli\u003eProvides advice and/or tools on how the recommendations can be put into practice (NICE, IETSI. POAG-PPP-2020, SNSG, MaHTAS, FCCG, partially in AOA).\u003c/li\u003e\n \u003cli\u003ePotential resource implications of applying the recommendations have been considered (NICE, EGS-5-TGG, POAG-PPP-2020, SNSG, FCCG, AOA).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003ePresents clinical monitoring criteria (NICE, IETSI, MaHTAS, SNSG, partially reported (only clinical criteria) in EGS-5-TGG, POAG-PPP-2020, JGSG, NSG, FCCG, AOA).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eNo description of how the information influenced the guideline development process and/or formation of the recommendations (NICE, JGSG, NSG, APGG).\u003c/li\u003e\n \u003cli\u003eDoes not describe facilitators and barriers to its application (EGS-5-TGG, JGSG, FCCG, APGG).\u003c/li\u003e\n \u003cli\u003ePotential resource implications have not been considered (IETSI, MaHTAS, JGSG, NSG, APGG).\u003c/li\u003e\n \u003cli\u003eNo clinical monitoring criteria present \u0026nbsp;(APGG)\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6. Editorial independence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eCompeting interests of guideline development group members have been recorded and addressed (NICE, IETSI, POAG-PPP-2020, SNSG, JGSG, FCCG, APGG, AOA).\u003c/li\u003e\n \u003cli\u003eGuideline report details about funding body (MaHTAS, APGG, partially in AOA).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cul\u003e\n \u003cli\u003eNo description about funding body or competing interests of guideline development group is available (EGS-5-TGG, NSG)\u003c/li\u003e\n \u003cli\u003eThere\u0026rsquo;s no statement that the views of the funding body have not influenced the content of the guideline (all guidelines).\u003c/li\u003e\n \u003cli\u003eCompeting interest of guideline development group are not described (MaHTAS, NSG).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7. Overall Guideline Assessment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 648px;\"\u003e\n \u003cp\u003eRecommended:\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003eNo: AOA, APGG, FCCG, NSG, JGSG, IETSI, POAG-PPP-2020\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eYes, with modifications: EGS-5-TGG, SNSG, MaHTAS\u003c/li\u003e\n \u003cli\u003eYes, without modifications: NICE\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Comments specific to certain CPGs are indicated in parentheses; comments lacking denotations\u0026nbsp;pertain to all eleven CPGs.\u003c/p\u003e\n\u003cp\u003eAOA: American Optometric Association\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;APGG: Asia Pacific Glaucoma Guidelines \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;FCCG: Finnish Current Care Guideline\u003c/p\u003e\n\u003cp\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline\u0026nbsp; \u0026nbsp;NICE: National Institute for Health and Care Excellence\u003c/p\u003e\n\u003cp\u003eEGS: European Glaucoma Society IETSI:\u0026nbsp;Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/p\u003e\n\u003cp\u003ePPP:\u0026nbsp;Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/p\u003e\n\u003cp\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5: Recommendations Matrix of clinical practice guidelines for the diagnosis and management of OAG (Guideline clinical recommendation meta-synthesis).\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"1099\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(2024)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAPGG\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(2024)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFCCG \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;(2024)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNSG \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; (2024)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eJGSG\u003cbr\u003e\u0026nbsp;(2023)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNICE\u003cbr\u003e\u0026nbsp;(2022)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEGS-5-TGG\u0026nbsp;\u003cbr\u003e\u0026nbsp;(2021)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIETSI\u003cbr\u003e\u0026nbsp;(2021)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePOAG-PPP-2020\u003cbr\u003e\u0026nbsp;(2020)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSNSG\u003cbr\u003e\u0026nbsp;(2017)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaTHAS\u003cbr\u003e\u0026nbsp;(2017)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors /predictors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eOcular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eElevated IOP, myopia, corneal thickness, corneal hysteresis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eHigher IOP, thinner central cornea, myopia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eAge, IOP, pseudo exfoliation with Ocular Hypertension (OHT), optic nerve head hemorrhage, myopia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eElevated IOP, exfoliation syndrome, moderate to high myopia, optic disc hemorrhages, pigment dispersion syndrome, thin CCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eElevated IOP, thin CCT, large C/D ratio, small optic nerve rim area, disc hemorrhage, large \u0026beta;-zone of peripapillary chorioretinal atrophy, low corneal hysteresis, low ocular perfusion pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eLevel of IOP, CCT\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eElevated IOP, disc hemorrhage, myopia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eElevated IOP, myopia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eElevated IOP, thin CCT, myopia, low ocular perfusion pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eElevated IOP, myopia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eElevated and/or asymmetry of IOP, thinner CCT, myopia, corneal hysteresis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eIncreasing age, genetics and positive family history, race/ethnicity, type 2 diabetes mellitus, hypertension/hypotension\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eOlder age, family history of glaucoma, race or ethnicity (Hispanics/Latinos, Africans and South Central Asians), low diastolic perfusion pressure (\u0026lt;50 mmHg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eFamily history of glaucoma, African ancestry, reduced perfusion pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eOlder age, family history, non-Caucasian ethnicity (mainly African), low diastolic blood pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eAge, family history of glaucoma, low diastolic and systolic blood pressure, type 2 diabetes, exfoliation syndrome, poor drug adherence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eFamily history, life expectancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eOlder age, non-White ethnicity (particularly Black), family history of glaucoma, pseudo exfoliation, low diastolic blood pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eOlder age, black and/or hispanic ethnicity, family history of glaucoma, diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eOlder age, family history of glaucoma, African race or Latino/Hispanic ethnicity, type 2 diabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eAge, ethnicity (predominantly black), diabetes, family history of glaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eOlder age; West African, Afro-Caribbean or Hispanic/Latino ethnicity; positive family history, Obstructive Sleep Apnea Syndrome, diabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScreening\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eThe evidence is insufficient to assess the benefits and harms of glaucoma screening in asymptomatic adults.\u003c/p\u003e\n \u003cp\u003eScreening in the general population has not been found to be cost-effective.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eIn the general population is not recommended\u003c/p\u003e\n \u003cp\u003eIn certain populations with a high risk of glaucoma blindness\u003c/p\u003e\n \u003cp\u003eand low screening costs, community-based screening can be cost-effective.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eNot Recommended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eNot Recommended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eScreening is more useful and cost-effective when it is targeted at populations at high risk of glaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eIt is suggested to perform glaucoma screening in patients with risk factors for developing the disease\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eShould be considered for patients with risk factors, especially: age \u0026gt;40 years, family history of glaucoma, diabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTarget IOP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eMay change depending on the results of long-term monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eTarget IOP should be individualized and reviewed at every follow-up visit based on disease severity, rate of progression, and life expectancy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eAdjusted at each follow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eContinuously evaluated and adjusted\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSet according to the stage of glaucoma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003ePrefer \u0026lsquo;clinically acceptable control of IOP\u0026rsquo;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eUpdated at each monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eTarget IOP will be determined and adjusted individually for each patient based on the treating physician\u0026acute;s criteria and periodic reevaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eIndividualized and adjusted further down or even up during the disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eIt is reasonable to aim for a 25 to 50% reduction in baseline IOP without treatment, depending on the level of PIO, stages, age, presence of risk factors, rate of progression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eIndividualized and adjusted during the disease\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCentral corneal thickness (CCT) correction\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eIs indicated as part of the evaluation of the patient with suspected glaucoma or ocular hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGonioscopy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eYes. Anterior segment-optical coherence tomography should not serve as a replacement for gonioscopy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eYes.\u003c/p\u003e\n \u003cp\u003eOCT-A can more precisely evaluate iris trabecular contact\u003c/p\u003e\n \u003cp\u003e(ITC) in 360\u0026deg; compared with gonioscopy.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eCannot be replaced by automated imaging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eYes, static and dynamic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eIf not available, use OCT or Van Herick.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes. Use UBM exceptionally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eIf impossible, choose Van Herick\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eYes, static and dynamic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStandard Automated Perimetry (SAP)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eIs a fundamental test for detecting visual field loss and for monitoring the rate of visual field change over time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eA personalized testing strategy is advisable. This tailored approach ensures that each patient receives optimal care tailored to their specific condition\u003c/p\u003e\n \u003cp\u003eFactors such as disease stage, patient\u0026rsquo;s age, and current progression status should\u003c/p\u003e\n \u003cp\u003eguide the frequency of VF testing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eUse the same instrument and protocol for follow-up. 2-6 VF are needed to confirm progression. In advanced glaucoma monitor progression with central 10-degree VF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e5\u0026ndash;6 Visual Field (VF) during the first 2 years, except patients with newly discovered OHT. Adapt the stimulus intensity and size according to the stage of glaucoma.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eMinimum of 5 VF to determine progression.\u003cbr\u003e\u0026nbsp;Newly diagnosed glaucoma: measure as frequently as possible during the first 2 years.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eEstablish a baseline and severity of impairment at diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e3 times per year during the first 2 years in newly diagnosed patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eRepeat the same strategy that showed a new glaucomatous defect to confirm VF damage progression.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eMinimum of 6 VF in the first 2 years of diagnosis to calculate rate and progression\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eChange stimulus size and strategy in advanced disease\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOCT for diagnosis and follow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eYes. Is useful for documenting the status and progression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eOCT is a complementary tool rather than a replacement for a\u003c/p\u003e\n \u003cp\u003ecomprehensive clinical evaluation.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eDo not diagnose or assess progression based on OCT alone. Examinations with different devices are not comparable.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eRepeated examinations may show false positive progression. Floor effect in advanced glaucoma complicates assessment.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSuitable for early stages. Not recommended in advanced glaucoma (floor effect)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eUseful for baseline documentation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eDon\u0026apos;t diagnose solely on OCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eManagement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eLaser trabeculoplasty as first line treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNo:\u003c/p\u003e\n \u003cp\u003eIt is used as an alternative treatment for patients who cannot achieve target IOP using drug therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNo:\u003c/p\u003e\n \u003cp\u003eIf bad adherence to pharmacological treatment is expected\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eNo:\u003c/p\u003e\n \u003cp\u003eIf bad pharmacological treatment adherence is expected. Don\u0026apos;t\u0026nbsp;associate with pharmacological treatment in patients with uncontrolled glaucoma.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eProstaglandin analogues (PGA) as first-line drug\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eYes.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eOther considerations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003ePatients prescribed topical IOP lowering therapy may experience decreased tear film stability and elevated tear osmolarity and should be evaluated for ocular surface disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNew medications and classes of drugs have been developed recently (selective EP2 receptor agonist and Rho kinase inhibitors), broadening our treatment options\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eBeta blocker can be chosen as first line treatment. Fixed combination of PGA and beta blocker reduce IOP more than other combinations.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eFor good adherence, a fixed combination is usually chosen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eDrug therapy is the first -line treatment for primary open-angle glaucoma.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eDo not offer treatment to people with suspected chronic open angle glaucoma (COAG) and IOP less than 24 mmHg unless they are at risk of visual impairment within their lifetime. Advise people to continue regular visits to their primary eye care professional.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eFixed combination is preferable to multiple drugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eStart treatment with two drugs in patients with high initial IOP\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eFixed combinations are not recommended for initial treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eIn people with open-angle glaucoma, initial treatment with beta-blockers is recommended if prostaglandin analogues cannot be used\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eFixed combinations provide improved long-term adherence compared with non-fixed components\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eLaser trabeculoplasty or Surgery indication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eMedical therapy failure in achieving optimal IOP control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eIf insufficient response, intolerance to treatment or progression, despite lowered IOP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eIf more than 3 drugs are required to achieve target IOP\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eWhen multiple medications are required\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eAfter treatment with medicines from 2 therapeutic classes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eWhen insufficiently controlled with two or three agents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eConsider if there is no response to medical treatment, or if there is progression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eIf more than two medications are required to achieve target IOP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eTrabeculectomy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eIs therefore a long-term management option for IOP control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eThe procedure is conventionally considered the gold standard of penetrating surgery\u003c/p\u003e\n \u003cp\u003eto create a subconjunctival bleb without the need of an implant, resulting in a cost-effective\u003c/p\u003e\n \u003cp\u003eapproach to the surgical treatment of glaucoma.\u003c/p\u003e\n \u003cp\u003eIs the most performed glaucoma filtering surgery.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eComplication\u0026rsquo;s area more frequent than in non-penetrating surgeries\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eGold standard\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eInitial treatment for patients with inadequate control of IOP by drug therapy or laser therapy or for severe cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eOffer people with advanced chronic open angle glaucoma (COAG), glaucoma surgery with pharmacological augmentation (Mitomycin C - MMC) as indicated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eWhen other forms of therapy have failed to control the disease or are not suitable; and target pressure is unlikely to be achievable with topical medications and/or laser.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eAdults with primary open angle glaucoma (POAG) that do not meet target IOP despite maximum tolerated pharmacological/laser treatment, are not suitable for pharmacological/laser treatment, or present advanced glaucoma damage at diagnosis.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eIndicated when medications and appropriate laser therapy are insufficient to control disease; can be considered as initial therapy in selected cases.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eIn severe glaucoma and in cases with a high risk of progression despite optimal medical treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003ePrimary surgery of choice in primary open angle glaucoma (POAG)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eCombined trabeculectomy with cataract surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eBetter IOP lowering than cataract surgery alone, but lower success rate than filtering surgery alone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eWeakly recommended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eIOP reduction is more than phacoemulsification alone. Success rate is less than filtration surgery alone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eNot as effective as glaucoma surgery alone in lowering IOP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eSignificantly lower mean IOP than phacoemulsification alone\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eMIGS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eGeneral information about characteristics. Mention Trabectome surgery used in combination with cataract surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eOffer indications for use, recommendations enhance the success of implantation and recommendations postoperative management for trabecular meshwork MIGS (stents and procedures).\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eBrief comment about MIGS.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNo evidence of the efficacy compared to traditional glaucoma surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eGeneral information about characteristics, classification, and indications.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSuitable in early or moderate glaucoma. Not sufficient information on long-term effects and safety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eProcedure should be performed by a surgeon with sufficient experience in anterior chamber angle surgery. Mentions: EX-PRESS, ab interno trabeculotomy (with metal hook, nylon thread or, trabectome) and iStent.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eA list of available techniques.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMild to moderate glaucoma. It is possible to combine it with phacoemulsification. Doesn\u0026apos;t precise specific techniques.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eDescription list of techniques. Some are only FDA approved to be performed concurrently with phacoemulsification.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLess effective in lowering IOP than trabeculectomy and GDD. More favorable safety profile in the short term. Mentions: Trabectome, KDB, GATT with iTrack or suture, ABiC, iStent and iStent inject, Hydrus microstent, Xen gel stent.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eLack of descriptions and recommendations \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eNot recommended\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eNon-penetrating deep sclerectomy (NPDS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNon-penetrating glaucoma surgery (NPGS) reduces IOP less effectively\u003c/p\u003e\n \u003cp\u003ethan penetrating surgery, but with lower complication\u003c/p\u003e\n \u003cp\u003erates.\u003c/p\u003e\n \u003cp\u003eNPGS may reduce the hypotony risks of trabeculectomy in higher-\u003c/p\u003e\n \u003cp\u003erisk patients, e.g., high myopes, younger patients, previous\u003c/p\u003e\n \u003cp\u003evitrectomy, eye-rubbers.\u003c/p\u003e\n \u003cp\u003eSurgeon preference based on training and experience determines the preferred procedure (NPGS versus trabeculectomy)\u003c/p\u003e\n \u003cp\u003efor the particular patient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eBrief comment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eBrief comment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eBrief comment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eDescription of technique and brief comment about Deep sclerectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eDescription of technique and offers recommendations (1 general and 4 specific)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eBrief comment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eGlaucoma drainage devices (GDD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eBaerveldt GDDs resulted in greater IOP reduction but more early and serious complications than was encountered with patients receiving Ahmed valves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eIndications: previous failed trabeculectomy \u0026nbsp;with antimetabolites, insufficient conjunctiva due to scarring, complicated and refractory glaucomas.\u003c/p\u003e\n \u003cp\u003eNon-valved drainage devices result in greater postoperative hypotony than valved devices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eHigher success rate than trabeculectomy in eyes with previous intraocular surgery\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eFirst-line surgical procedure in some cases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003ePatients with unsuccessful trabeculectomy with concomitant use of antimetabolites, severe conjunctival scarring because of previous surgery, those who are unlikely to achieve successful trabeculectomy or technically cannot undergo other filtration procedures. Less effective in lowering IOP than trabeculectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003ePatients with risk factors for a poor result of trabeculectomy with antifibrotics. Potential role as a primary surgical procedure in selected cases.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003ePatients who do not meet target IOP or evidence a progression in visual field damage despite maximum tolerated pharmacological treatment and trabeculectomy, or when trabeculectomy has a high failure rate.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eIndicated when trabeculectomy has failed to control IOP or is deemed unlikely to succeed. Use patch allografts of sclera, cornea, or pericardium to prevent tube erosion.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003ePatients that have not controlled IOP despite pharmacological treatment, or when filtering surgery has failed. GDDs are not the first choice of surgical treatment in na\u0026iuml;ve patients.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003ePatients with high risk of failure from augmented trabeculectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eLens extraction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eFor patients with POAG results in a modest IOP decrease (13%), reduced medication requirement (12%). Some patients (up to 26%), however, experience worse IOP control and may require additional medications, laser surgery or both\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eThere is insufficient evidence to support that IOP reduction from cataract surgery\u003c/p\u003e\n \u003cp\u003ecan protect against VF deterioration.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eMight impair the filtration of a previous glaucoma surgery. The risk is lower if there is a time gap of over 12 months between surgeries.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eConsider early cataract surgery in patients with glaucoma.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eCataract surgery alone as an intervention to control glaucoma is not recommended. Performed after trabeculectomy can affect the IOP control.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eMultifocal intraocular lenses may have adverse effects on contrast sensitivity and visual field performance in patients with glaucoma.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eThe risk of bleb failure is reduced if lens extraction is performed \u0026gt; 6 months post-trabeculectomy.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eCyclodestructive procedures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003ePatients treated with endocyclophotocoagulation via the pars plana had lower IOPs, needed fewer glaucoma medications, and had a higher success than patients similarly treated via the limbus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eBoth forms of diode lasers ( micropulse and standard) are effective forms of trans-scleral cyclophotocoagulation of ciliary body ablation. MicroPulse is thought to be safer, but less efficacious in terms of IOP lowering compared with standard cyclodiode. The technique chosen is based on surgeon preference and equipment availability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eEffective and safe in difficult-to-treat glaucoma. Repeated treatments are often required.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eWhen filtering surgery has not worked/is not effective enough or not feasible and in painful blind eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eRefractory cases in which other treatments are ineffective because it can cause vision threatening complications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eOffer cyclodiode laser treatment to people with chronic open angle glaucoma (COAG) (including advanced COAG) who prefer not to have glaucoma surgery or whom glaucoma surgery is not suitable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eIndicated when filtration surgery or GDD are likely to fail/have failed/are not feasible; and in refractory glaucoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eAdults with primary open angle glaucoma (POAG) that don\u0026apos;t meet target IOP despite treatment, patients that cannot have glaucoma drainage devices (GDD) implanted, and in painful blind eye\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eEyes with limited visual potential or that are otherwise poor candidates for incisional ocular surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eIndicated in painful blind eyes or eyes with poor vision, failed multiple filtering surgeries. May be performed in sighted eyes when the benefits outweigh the risks for incisional surgery.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther issues\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePatient education and adherence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eRecommended.\u003c/p\u003e\n \u003cp\u003eEye doctors should be persistent in providing education and training to improve adherence/compliance with recommended therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eRecommended.\u003c/p\u003e\n \u003cp\u003eAdherence can be improved by identifying the barriers and addressing them strategically\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eIt is unclear whether patient education improves compliance\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eRecommended. Glaucoma schools create affinity and exchange of experience between patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eRecommended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eRecommended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eRecommended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eRecommended. Peer-support groups or counseling are helpful to some patients.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eRecommended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eRecommended\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePregnancy and breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003ePharmacological treatment of POAG should be used with caution during pregnancy and lactation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003ePresent or possible, renders all interventions potentially hazardous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eDiscuss with the doctor that is treating the pregnancy whether to star treatment or to monitor without treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNC\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eDrug therapy for glaucoma should be discontinued during pregnancy, childbirth, and lactation. Laser therapy or surgery should be considered if IOP control worsens upon discontinuation of the drug. There are no glaucoma medications for which safety has been established in pregnant women, fetuses, or nursing mothers.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eSpecific consideration in terms of discussions about management and pharmacological treatment.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eTemporary treatment discontinuation can be considered. No IOP-lowering medications have been labeled for use during pregnancy and/or breastfeeding. Systemic absorption should be reduced by punctal occlusion and eyelid closure. During breastfeeding, PGAs, carbonic anhydrase inhibitors and beta-blockers may be acceptable.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eNC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eThe American Academy of Pediatrics has approved the use of carbonic anhydrase inhibitors during lactation. Brimonidine can cause apnea in infants, toddlers, and children; therefore, is not recommended to be used in mothers who are breastfeeding.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003eVaginal delivery is not contraindicated and must only be evaluated in cases of severe or advanced glaucoma.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eThe ideal for newborn child, who is breastfed, is that de mother can control herself without medical treatment because all drugs can pass through the milk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eTopical beta-blockers can be the first-line medications when considering medical treatment of glaucoma in pregnancy.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNC: Not covered\u003c/p\u003e\n\u003cp\u003eAOA: American Optometric Association\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;APGG: Asia Pacific Glaucoma Guidelines \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;FCCG: Finnish Current Care Guideline\u003c/p\u003e\n\u003cp\u003eNSG: Nordic and Swedish guidelines JGSG: Japan Glaucoma Society Guideline\u0026nbsp; \u0026nbsp;NICE: National Institute for Health and Care Excellence\u003c/p\u003e\n\u003cp\u003eEGS: European Glaucoma Society IETSI:\u0026nbsp;Instituto de Evaluaci\u0026oacute;n de Tecnolog\u0026iacute;as en Salud e Investigaci\u0026oacute;n\u003c/p\u003e\n\u003cp\u003ePPP:\u0026nbsp;Preferred Practice Pattern SNSG: Sistema Nacional de Salud Guideline\u003c/p\u003e\n\u003cp\u003eMaHTAS: Malaysian Health Technology Assessment Section\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"Scientia Clinical and Epidemiological Research Institute","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4843576/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4843576/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cb\u003eBackground/Objectives\u003c/b\u003e:\u003c/p\u003e \u003cp\u003eTo assess the methodological quality of Clinical Practice Guidelines(CPG) for the diagnosis and management of open angle glaucoma(OAG).\u003c/p\u003e \u003cp\u003e \u003cb\u003eMethods\u003c/b\u003e:\u003c/p\u003e \u003cp\u003eA systematic review of CPGs for the diagnosis and management of OAG, published between January-2017 and November-2024, was carried out with a search in databases, meta-search engines, CPG development institutions, ophthalmology associations and CPG repositories(PROSPERO:CRD42024510656). 5 authors evaluated them independently, using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. An individual assessment by domain (AGREE-II), an overall assessment of the guide, and its use with or without modifications was performed. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes was carried out.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e:\u003c/p\u003e \u003cp\u003eThe lowest mean scores were in applicability and rigour of development(mean 43.2% and 46.1% respectively). The highest score(mean 73.9%) was for domain 4-\u0026lsquo;Clarity of presentation\u0026rsquo;. NICE(92.1%), IETSI(77.5%) and SNSG(75.8%) presented the best score in domain 3-\u0026lsquo;Rigour of development\u0026rsquo;. Only NICE, EGS-5-TGG, SNS, and MaHTAS are recommended, the last two with modifications when evaluating the overall quality of the analyzed CPGs. Most of the CPGs used GRADE approach for making recommendations. In the meta-synthesis, the CPGs show similar recommendations, however, we found variability in indications for selective laser trabeculoplasty(SLT) and minimally invasive glaucoma surgery(MIGS).\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusions\u003c/b\u003e:\u003c/p\u003e \u003cp\u003eNICE, IETSI and SNSG CPGs for the diagnosis and management of OAG have a high methodological quality, appraised with AGREE-II. NICE, EGS-5-TGG, IETSI and SNSG have high scores in applicability.\u003c/p\u003e","manuscriptTitle":"Systematic review of clinical practice guidelines for the diagnosis and management of open angle glaucoma","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2025-01-06 17:06:55","doi":"10.21203/rs.3.rs-4843576/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2024-08-05 20:28:49","doi":"10.21203/rs.3.rs-4843576/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"89c79230-1319-48e3-84f9-383984b61a40","owner":[],"postedDate":"January 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":42440373,"name":"Health sciences/Medical research/Epidemiology"},{"id":42440374,"name":"Health sciences/Medical research/Outcomes research"},{"id":42440375,"name":"Health sciences/Diseases/Eye diseases/Ocular hypertension/Glaucoma"}],"tags":[],"updatedAt":"2025-12-01T15:04:32+00:00","versionOfRecord":{"articleIdentity":"rs-4843576","link":"https://doi.org/10.1097/IJG.0000000000002642","journal":{"identity":"journal-of-glaucoma","isVorOnly":true,"title":"Journal of Glaucoma"},"publishedOn":"2025-09-30 00:00:00","publishedOnDateReadable":"September 30th, 2025"},"versionCreatedAt":"2025-01-06 17:06:55","video":"","vorDoi":"10.1097/IJG.0000000000002642","vorDoiUrl":"https://doi.org/10.1097/IJG.0000000000002642","workflowStages":[]},"version":"v2","identity":"rs-4843576","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4843576","identity":"rs-4843576","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}