Systematic Review of Clinical Practice Guidelines for the Diagnosis and Management of Open Angle Glaucoma

Galvez-Olortegui J.; Jarroudi R.B.-E.; Silva-Ocas I.; Bernales-Urbina S.; Mollo-Bautista R.; Burgueño-Montañes C.; Galvez-Olortegui T. · Journal of Glaucoma (2025) · DOI: 10.1097/ijg.0000000000002642

Resumen

Précis: – Clinical Practice Guidelines for Open Angle Glaucoma (OAG) have evolved through the years and differ in their methodological quality. British, Peruvian and Spanish guidelines have a high methodological quality. Topic: – To assess the methodological quality of Clinical Practice Guidelines for the diagnosis and management of open angle glaucoma (OAG). Clinical relevance: – An assessment of the methodological quality of Clinical Practice Guidelines for the diagnosis and management of open angle glaucoma (OAG) is reported. Methods: – A systematic review of Clinical Practice Guidelines 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, guidelines development institutions, ophthalmology associations and guidelines repositories (CRD42024510656). Guidelines were selected if they were published in English/Spanish during the last seven years. Five 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. High-quality guideline was considered with at least 3/6 domains>60% including domain 3. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes of each guideline was performed. Results: – Eleven guidelines (20% of the 55 guidelines retrieved) published in English/Spanish, between 2017 and 2024 were selected. The lowest mean scores were in applicability and rigour of development (mean 43% and 46% respectively). The highest score (mean 73%) was for domain four ‘clarity of presentation’. British (92%), Peruvian (77%) and Spanish (75%) guidelines presented the best score in domain three ‘Rigour of development’. When applying AGREE-II criteria for the overall guideline assessment, British and Spanish guidelines have the highest overall quality (6 and 5 scores respectively). Most of the guidelines used GRADE approach for making recommendations. In the meta-synthesis, the guidelines show similar recommendations, however, we found variability in indications for selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS). Conclusions: – British, Peruvian and Spanish guidelines for the diagnosis and management of OAG have a high methodological quality, and high scores in applicability. On the other hand, European guideline have high scores in applicability and moderate quality.

Instituciones: Universidad Nacional Santiago Antúnez de Mayolo