Which list represents unaccounted risk factors with OHTS?

• A. FHx, CH, systemic risk factors, OCT appearance, OPP
• B. Age, sex, race
• C. IOP alone
• D. Visual acuity

Answer: (A)

Unaccounted risk factors in this context are influences on the chance of converting from ocular hypertension to glaucoma that weren’t included in the original OHTS risk model. Family history signals a genetic predisposition to glaucoma, and corneal hysteresis reflects corneal biomechanics that can affect how the optic nerve tolerates elevated IOP; both were not part of the OHTS prediction formula. Systemic risk factors, such as vascular health and blood pressure, can influence optic nerve perfusion and damage risk but were not fully incorporated into the study’s risk calculation. OCT appearance provides modern imaging markers of structural change to the optic nerve and retinal nerve fiber layer that weren’t used in the original risk estimation. Ocular perfusion pressure, which combines blood pressure and IOP to estimate blood flow to the optic nerve, is another factor linked to risk that wasn’t included in the primary OHTS model. Taken together, these represent influences on glaucoma risk that were not addressed by the study’s predictive framework.

The other options emphasize factors that are more directly tied to what OHTS used or to factors that aren’t standalone predictors of conversion. Age, sex, and race were part of the broader clinical considerations around risk, and relying on IOP alone does not capture the multifactorial nature of progression. Visual acuity isn’t a primary driver of progression risk in the context of OHTS.