Ophthalmic Clinical Trials: We've Come a Long Way, Baby

[...]had the changes in the appearance of the optic disc or visual field not been further refined by the EPC “experts,” the recently published analysis2 indicates that the apparent size of the impact would have been considerably smaller, as IOP-lowering medication was unlikely to reduce the risk of other causes of apparent visual field deterioration (age-related macular degeneration, retinopathy, droopy lid) or optic disc erosion (optic neuritis, and so forth). Because of the EPC the study outcome was more accurate, and glaucoma management was finally based upon hard, reliable data, not “clinical impression.” In 1 or more decades, new algorithms, based upon more readily quantifiable data collected from visual field and optical coherence tomography testing, and powered by artificial intelligence and deep learning, will probably do a better job at standardized, reproducible diagnoses than we now do, particularly when it comes to endpoints of interest in clinical trials.