BACKGROUND: @entity726 is the leading cause of irreversible @entity1939 in the world. Estimated to affect 60 million @entity1 worldwide, this figure is expected to rise to 80 million by 2020. Untreated, @entity726 leads to @entity227 and eventually to @entity1939 , and can significantly reduce quality of life. First-line treatment in @entity1 with primary @entity1538 and @entity9998 is topical medical therapy with ocular @entity551 as eye drops. However, eye drops have several disadvantages including cost, possible local and systemic side effects, and adherence and perseverance issues. Randomised controlled trials have demonstrated that selective laser trabeculoplasty is equally as effective in lowering intraocular pressure as eye drops. However, the impact of these two treatment modalities from the @entity1 and economic perspectives has not been adequately determined. Thus, it remains unclear whether topical medical therapy or selective laser trabeculoplasty should be recommended as first-line treatment for @entity726 . METHODS/DESIGN: This protocol describes an international, multi-centre, randomised controlled trial to determine the optimum first-line therapy for @entity1 with primary @entity1538 and @entity9998 . This study will compare the effect of selective laser trabeculoplasty and topical medication with respect to @entity1 ' generic and @entity726 -specific quality of life. The trial will also provide a detailed cost-effectiveness analysis and compare the clinical effectiveness with respect to the degree of intraocular pressure lowering and rates of treatment failure. Research coordinators in each centre will identify and recruit previously untreated @entity1 with primary @entity1538 and @entity9998 . Those who meet the eligibility criteria will be invited to enter a randomised controlled trial with either selective laser trabeculoplasty or topical @entity551 therapy, according to a stepped regimen. Outcome assessment will be measured at 6 weeks and at 6, 12, and 24 months post-treatment. Regular clinic follow-ups will continue as clinically indicated between study outcome visits. DISCUSSION: The @entity726 Initial Treatment Study is the first multi-centred RCT to determine the optimum first-line therapy for @entity1 with @entity726 . Our trial will have an unprecedented capacity to meaningfully transform the treatment and management of @entity726 in Australia and overseas. TRIAL REGISTRATION: ACTRN12611000720910 ; Date registered: 11 July 2011.

Comparing the effectiveness of selective laser trabeculoplasty with topical medication as initial treatment (the XXXX Initial Treatment Study): study protocol for a randomised controlled trial.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'people'] @entity227 :: ('MESH:D014786', 'Disease') :: ['visual decay'] @entity1538 :: ('MESH:D005902', 'Disease') :: ['open-angle glaucoma'] @entity9998 :: ('MESH:D017889', 'Disease') :: ['exfoliative glaucoma'] @entity726 :: ('MESH:D005901', 'Disease') :: ['Glaucoma', 'glaucoma'] @entity1939 :: ('MESH:D001766', 'Disease') :: ['blindness'] @entity551 :: ('MESH:D007022', 'Disease') :: ['ocular hypotensive', 'hypotensives']
@entity726 :: (MESH:D005901,Disease) :: ['Glaucoma']
