Optic Nerve Head Drusen: The Relationship Between Intraocular Pressure and Optic Nerve Structure and Function: Response

We agree that a multicenter, double-blinded randomized control trial would represent the best study design to prove or disprove the efficacy of IOP lowering medications in ONHD eyes. The slow rate of visual field loss progression in most patients with ONHD combined with the inherent high costs of prospective treatment trials has hindered such a study. In the absence of a prospective treatment trial, our multicenter retrospective analysis of 236 eyes (more than double the next largest published study on the topic) to evaluate for evidence of a relationship between IOP and perimetric field depression was an achievable study with significant clinical merit.