Clarifying the Optimal Application of SLT Therapy Trial (COAST)

  • Sponsor: West Virginia University
  • Principal Investigator: Yao Liu, MD
  • Study Coordinator: Kelly Boyd

Study Objective:

The goal of this study is to understand if SLT performed at low energy is as effective as SLT performed at standard energy, and also to see if repeating SLT at low energy once a year will prevent or delay the need for daily eye drop medications better than waiting for SLT to wear off before repeating it.

Study Design:

Subjects will receive either low energy or standard energy SLT that will be repeated annually or as needed over a 4-year period.

Inclusion Criteria:

  • Newly diagnosed and treatment naïve (no prior IOP-lowering treatments)
  • Age 18 years or older
  • Each eye with BCVA at least 20/200
  • Each eye with one of the following qualifying diagnoses (diagnoses may differ between eyes):
    • High-risk ocular hypertension (OHT): IOP > 21 mmHg without glaucomatous optic neuropathy (excavation, diffuse or focal thinning or notching of the neuroretinal rim, visible nerve fiber layer defects, or asymmetry of the vertical cup-to-disc ratio of >0.2 between eyes) [enrollment of trial participants with High-risk OHT will be capped at 25% of total enrollment]
    • Mild primary open-angle glaucoma: glaucomatous optic neuropathy, visual field mean deviation >-6.0 dB with no points in the central 5° <15 dB
    • Moderate primary open-angle glaucoma: glaucomatous optic neuropathy, visual field mean deviation -6.0 dB to >-12 dB and no more than 1 central 5° point <15 dB

Exclusion Criteria:

  • Advanced POAG in either eye
  • Glaucoma other than POAG (including pigmentary and pseudoexfoliation glaucoma) in either eye
  • Mean IOP > 35 mmHg at either the screening or baseline visit in either eye
  • Narrow or closed angle (Shaffer Grade 0, 1, or 2) in either eye
  • Contraindications to SLT, brimonidine, or any other study intervention
  • Any corneal pathology that would preclude accurate assessment of IOP by Goldmann tonometry in either eye
  • Any intraocular surgical procedure within the past 6 months in either eye

Please contact Kelly Boyd with questions at 608-265-4589. For more information about this study: