Prevalence of Open-angle Glaucoma in Australia: The Blue Mountains Eye Study

doi:10.1016/S0161-6420(96)30449-1

Ophthalmology

Volume 103, Issue 10, October 1996, Pages 1661-1669

https://doi.org/10.1016/S0161-6420(96)30449-1 Get rights and content

Purpose: The purpose of this study was to determine the prevalence of open-angle glaucoma and ocular hypertension in an Australian community whose residents are 49 years of age or older.

Subjects: There were 3654 persons, representing 82.4% of permanent residents from an area west of Sydney, Australia, who were examined. The population was identified by a door-to-door census of all dwellings and by closely matched findings from the national census.

Methods: All participants received a detailed eye examination, including applanation tonometry, suprathreshold automated perimetry (Humphrey 76-point test), and Zeiss stereoscopic optic disc photography. Glaucoma suspects were asked to return for full threshold fields (Humphrey 30-2 test}, gonioscopy, and repeat tonometry.

Results: A 5-point hemifield difference on the 76-point test was found in 616 persons (19% of people tested). Humphrey 30-2 tests were performed on 336 glaucoma suspects (9.2% of population), of whom 125 had typical glaucomatous field defects. Two hundred three persons had enlarged or asymmetric cup-disc ratios (≥0.7 in 1 or both eyes or a cup-disc ratio difference of ≥0.3). Open-angle glaucoma was diagnosed when glaucomatous defects on the 30-2 test matched the optic disc changes, without regard to the intraocular pressure level. This congruence was found in 87 participants (2.4%), whereas an additional 21 persons (0.6%) had clinical signs of open-angle glaucoma but incomplete examination findings. Open-angle glaucoma was thus found in 108 persons, a prevalence of 3.0% (95% confidence interval [Cl], 2.5–3.6), of whom 49% were diagnosed previously. An exponential rise in prevalence was observed with increasing age. Ocular hypertension, defined as an intraocular pressure in either eye greater than 21 mmHg, without matching disc and field changes, was present in 3.7% of this population (95% Cl, 3.1–4.3), but there was no significant age-related increase in prevalence. The prevalence of glaucoma was higher in women after adjusting for age (odds ratio, 1.5; Cl, 1.0–2.2). There was no sex difference in the age-adjusted prevalence of ocular hypertension.

Conclusions: These data provide detailed age and sex-specific prevalence rates for open-angle glaucoma and ocular hypertension in an older Australian population.

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Epidemiological and clinical features of primary open angle glaucoma in Bejaia: “The Bejaia Eye Study”
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L’objectif de notre étude est de déterminer la prévalence du GPAO et ses aspects cliniques et épidémiologiques chez une population âgée de 40 ans et plus dans la commune de Bejaia.
Il s’agit d’une enquête descriptive, transversale à visée analytique auprès d’un échantillon représentatif de la commune de Bejaia. La population cible est représentée par les résidents et résidentes de la commune, âgés de 40 et plus, consultant aux niveaux des structures sanitaires de base de la commune de Bejaia, du 31 mai 2015 au 12 juillet 2016. Tous les sujets ont été examinés selon un protocole standard. Le critère du champ visuel, de l’OCT, du rapport C/D vertical et de la pression intraoculaire ajustée, ont été utilisés pour définir la présence ou non d’un glaucome primitif à angle ouvert (classification ISGEO et OCT).
Au total, 1484 personnes ont participé à l’étude. La moyenne d’âge de la population d’étude est de 57,97 ± 10,77 ans avec une médiane à 56 ans, et un sex-ratio de 1,07. La prévalence du glaucome dans notre étude est de 5,5 % : le GPAO : 4,6 %, (intervalle de confiance à 95 % [IC 95 %] : 3,5–5,7) ; le GCFA 0,3 %, (IC 95 % : 0,1–0,7) ; les glaucomes secondaires 0,5 %, (IC 95 % : 0,2–0,9). La prévalence de l’hypertonie oculaire est de 3,0 % (IC 95 % : 2,2–4,0). La prévalence ajustée à l’âge est de 0,8 % entre 40 et 49 ans et 6,9 % entre 60 et 69 ans. La moyenne d’âge est de 66,76 ± 9,31 ans chez les hommes et 67,68 ± 12,10 ans chez les femmes. Le GPAO a été bilatéral dans 84 % des cas. La PIO moyenne est de 17,75 ± 6,17 mm Hg dans le groupe de patients atteints de GPAO et 20,25 5,49 mm Hg dans le groupe ayant présenté une HTO isolée. La pachymétrie moyenne est de 518,3 ± 34,3 microns à l’œil droit et de 517,4 ± 33,9 microns à l’œil gauche. Le rapport cup/disc moyen est de 0,7 ± 0,2 aux deux yeux. L’analyse multivariée des facteurs de risque dans notre étude a montré que l’âge et l’hypertonie oculaire étaient significativement associée à la présence du glaucome.
La prévalence du GPAO est élevée, similaire à celle des personnes d’origine sud-africaine, mais aux âges plus avancés et chez les hommes. La prévalence du GPAO est passée de 0,8 % avant 50 ans à 7 % vers 60 ans et plus. Le glaucome est un problème majeur de santé oculaire et deviendra de plus en plus important avec le vieillissement de la population.
To determine the prevalence of POAG and its clinical features in a population aged 40 years and over in Bejaia.
This was a descriptive, cross-sectional survey for analytical purposes in a representative sample from the municipality of Bejaia. The target population consists of residents of the municipality aged 40 and over who were examined in basic health facilities in the municipality of Bejaia, from May 31, 2015 to July 12, 2016. The visual field, OCT, vertical C/D and intraocular pressure (IOP) criteria were used to define whether or not primary open angle glaucoma was present.
A total of 1484 people (99 %) participated in the study. The mean age of the study population was 57.97 ± 10.77 years, with a median of 56 years and sex ratio of 1.07. The prevalence of glaucoma in our study was 5.5 %: POAG 4.6 % (95% CI = 3.5–5.7); PACG 0.3 % (95 % CI = 0.1, 0.7); secondary glaucoma 0.5 % (95 % CI = 0.2–0.7). The prevalence of ocular hypertension was 3.0 % (95% CI = 2.2–4.0). The age-adjusted prevalence was 0.8 % between 40 and 49 years of age and 6.9% between 60 and 69 years of age. The mean age was 66.76 ± 9.31 years for men and 67.68 ± 12.10 years for women. The mean IOP was 17.53 ± 5.69 mm Hg. The mean pachymetry was 518.3 ± 34.3 μm in the right eye and 517.4 ± 33.9 μm in the left eye. The mean cup/disc ratio was 0.7 ± 0.2 in both eyes. Multivariate analysis of risk factors in our study showed that age and ocular hypertension were significantly associated with the presence of POAG.
The prevalence of POAG is disparate in relation to the age difference, the method of recruitment and the diagnostic criteria: in Bejaia, it is 4.6 %; in Morocco: Marrakech 2.0 %, Fez 6.4 %; in Tunisia: Bardo 2.7 %, Mahdia 2.4 %. The prevalence of POAG increases exponentially with age without significant gender difference. The inclusion of suspect cases influences the prevalence (Beaver Dam, Namil Study). We found that the prevalence of OHT in our study approximates that of the BMES, but it did not show a significant increase with age. The mean CCT in Bejaia (526.35 ± 34.86 microns) and Fez (522.16 ± 41.45 microns) are comparable. The mean vertical C/D ratio in Bejaia was also comparable to data in the literature. A significant difference was observed in the mean median deviation (MD) between subjects with glaucoma and normal subjects. The retinal nerve fiber layer as well as the mean ganglion cell complex thickness in glaucoma subjects was significantly thinner than in healthy subjects.
The prevalence of POAG is high, similar to that of people of African descent, but at older ages and among men. The rate of glaucoma in Bejaia rises significantly with age. Glaucoma is a major ocular health problem and will become increasingly important as the population ages.
Natural History of Optic Disc With Physiologic Large Cup: Incidence, Predictors of Glaucoma Conversion After Minimum 10-Year Follow-up
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To investigate the natural history of optic disc with physiologic large cup (PLC) (ie, vertical cup/disc ratio [VCDR] ≥0.6 without retinal nerve fiber layer defect) and the risk factors for glaucoma conversion.
Observational retrospective cohort study.
Subjects who underwent a health screening examination at Seoul National University Hospital Healthcare System Gangnam Center from 2003 to 2010 (n = 76,030) were involved. The prevalence of PLC in the cohort was analyzed. The incidence rate of glaucoma conversion was estimated per 100 person-years among cases with a follow-up period longer than 10 years. Multivariate Cox proportional hazards regression was used to identify ocular and systemic factors associated with glaucoma conversion.
Among 74,617 eligible subjects, 3569 subjects (4.8%) had PLC. Of those with a follow-up period longer than 10 years (n = 859), the incidence rate of glaucoma conversion was 0.95 per 100 person-years. A total of 12.1% of PLC eyes progressed to glaucoma after 8.7 ± 3.9 years (range, 2.0-16.5 years). Higher VCDR (adjusted hazard ratio [aHR] = 4.36; 95% CI = 2.675-7.103), violation of the inferior superior nasal temporal neuroretinal rim thickness rule (aHR = 1.86; 95% CI = 1.057-3.258), presence of retinal arterial sclerosis (aHR = 1.63; 95% CI = 1.040-2.550), and lower total bilirubin level (aHR = 0.58; 95% CI = 0.340-0.991) were associated with glaucoma development.
This study identified the prevalence of PLC as well as the incidence rate of glaucoma conversion and the risk factors for glaucoma development in PLC eyes. The natural history of PLC may help clinicians to better understand its risk factors and the specific management needs of their patients.
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Significant visual impairment due to glaucoma is largely caused by the disease being detected too late.
To build a labeled data set for training artificial intelligence (AI) algorithms for glaucoma screening by fundus photography, to assess the accuracy of the graders, and to characterize the features of all eyes with referable glaucoma (RG).
Cross-sectional study.
Color fundus photographs (CFPs) of 113 893 eyes of 60 357 individuals were obtained from EyePACS, California, United States, from a population screening program for diabetic retinopathy.
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Proprietary or commercial disclosure may be found after the references.
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⁺: Supported by the Australian Department of Health, Housing and Community Services (RADGAC grant) and the Save Sight Institute, University of Sydney, Westmead, Australia.

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Prevalence of Open-angle Glaucoma in Australia: The Blue Mountains Eye Study+

Ophthalmology

Ophthalmology

Ophthalmology

Ophthalmology

Am J Ophthalmol

Ophthalmology

Ophthalmology

Ophthalmology

Intra-ocular pressure, glaucoma, and glaucoma suspects in a defined population

Br J Ophthalmol

Prevalence of glaucoma in the west of Ireland

Br J Ophthalmol

Alternative definitions of open-angle glaucoma. Effect on prevalence and associations in the Framingham eye study

Arch Ophthalmol

Revised Framingham eye study prevalence of glaucoma and diabetic retinopathy

Am J Epidemiol

Racial variations in the prevalence of primary open-angle glaucoma. The Baltimore Eye Survey

JAMA

The prevalence of glaucoma

Br J Ophthalmol

The middle-Norway eye-screening study. II. Prevalence of simple and capsular glaucoma

Acta Ophthalmol Suppl

Epidemiology of glaucoma in Japan: a nationwide glaucoma survey

Jpn J Ophthalmol

The Barbados Eye Study. Prevalence of open angle glaucoma

Arch Ophthalmol

The prevalence of open-angle glaucoma in Iceland

Acta Ophthalmol Suppl