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Open-angle glaucoma in an urban population in southern India: the Andhra Pradesh eye disease study.

Abstract

OBJECTIVE

To assess the prevalence and features of open-angle glaucoma in an urban population in southern India.

DESIGN

A population-based cross-sectional study.

PARTICIPANTS

A total of 2522 persons (85.4% of those eligible) of all ages, including 1399 persons 30 years of age or older, from 24 clusters representative of the population of Hyderabad city.

TESTING

The participants underwent an interview and detailed eye examination that included logarithm of minimum angle of resolution visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, dilatation, cataract grading, and stereoscopic fundus evaluation. Automated Humphrey threshold 24-2 visual fields (Humphrey Instruments Inc., San Leandro, CA) and optic disc photography were performed when indicated by standardized criteria for disc damage or if intraocular pressure (IOP) was 22 mmHg or more.

MAIN OUTCOME MEASURES

Definite primary open-angle glaucoma (POAG) was defined as obvious glaucomatous optic disc damage and visual field loss in the presence of an open-angle, and suspected POAG was defined as suspected glaucomatous optic disc damage without definite visual field loss. Ocular hypertension (OHT) was defined as IOP of 22 mmHg or more without glaucomatous optic disc damage or visual field loss in the presence of an open-angle. Glaucomatous optic disc damage or IOP of 22 mmHg or more secondary to an obvious cause and with an open-angle was defined as secondary open-angle glaucoma.

RESULTS

Definite POAG, suspected POAG, and OHT were present in 27, 14, and 7 participants, respectively, with age- and gender-adjusted prevalence (95% confidence interval) of 1.62% (0.77%-2.48%), 0.79% (0.39%-1.41%), and 0.32% (0.10%-0.78%) in those 30 years of age or older, and 2.56% (1.22%-3.91%), 1.11% (0.43%-1.78%), and 0.42% (0.11%-1.12%) in those 40 years of age or older, respectively. The prevalence of POAG increased significantly with age using multivariate analysis (P < 0.001). Only two of 27 participants (7.4%) with definite POAG had been previously diagnosed and treated, and 66.7% of the previously undiagnosed had IOP less than 22 mmHg. Fourteen of 27 participants (51.9%) with definite POAG had severe glaucomatous damage based on optic disc and visual field criteria, of which five participants (18.5%) had at least one blind eye as a result of POAG (all with best-corrected distance visual acuity less than 20/400 or central visual field less than 10 degrees); the other 13 participants (48.1%) had moderate glaucomatous damage. Because visual fields and optic disc photography were not performed on all participants, the prevalence of POAG may have been underestimated. Secondary open-angle glaucoma was present in one participant as a result of angle recession.

CONCLUSIONS

The prevalence of open-angle glaucoma in this urban population in southern India is at least as much as that reported recently from white populations in developed countries. However, the vast majority of persons with glaucoma were undiagnosed in this population, and a large proportion of those having definite POAG already had severe glaucomatous damage.

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  • Authors+Show Affiliations

    ,

    Public Health Ophthalmology Service, L.V. Prasad Eye Institute, Hyderabad, India. dandona@lvpeye.stph.net

    , , , , ,

    Source

    Ophthalmology 107:9 2000 Sep pg 1702-9

    MeSH

    Adolescent
    Adult
    Age Distribution
    Aged
    Aged, 80 and over
    Child
    Child, Preschool
    Cross-Sectional Studies
    Female
    Glaucoma, Open-Angle
    Humans
    India
    Infant
    Intraocular Pressure
    Male
    Middle Aged
    Photography
    Prevalence
    Sex Distribution
    Urban Population
    Visual Acuity
    Visual Field Tests
    Visual Fields

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10964833

    Citation

    Dandona, L, et al. "Open-angle Glaucoma in an Urban Population in Southern India: the Andhra Pradesh Eye Disease Study." Ophthalmology, vol. 107, no. 9, 2000, pp. 1702-9.
    Dandona L, Dandona R, Srinivas M, et al. Open-angle glaucoma in an urban population in southern India: the Andhra Pradesh eye disease study. Ophthalmology. 2000;107(9):1702-9.
    Dandona, L., Dandona, R., Srinivas, M., Mandal, P., John, R. K., McCarty, C. A., & Rao, G. N. (2000). Open-angle glaucoma in an urban population in southern India: the Andhra Pradesh eye disease study. Ophthalmology, 107(9), pp. 1702-9.
    Dandona L, et al. Open-angle Glaucoma in an Urban Population in Southern India: the Andhra Pradesh Eye Disease Study. Ophthalmology. 2000;107(9):1702-9. PubMed PMID: 10964833.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Open-angle glaucoma in an urban population in southern India: the Andhra Pradesh eye disease study. AU - Dandona,L, AU - Dandona,R, AU - Srinivas,M, AU - Mandal,P, AU - John,R K, AU - McCarty,C A, AU - Rao,G N, PY - 2000/8/31/pubmed PY - 2000/9/23/medline PY - 2000/8/31/entrez SP - 1702 EP - 9 JF - Ophthalmology JO - Ophthalmology VL - 107 IS - 9 N2 - OBJECTIVE: To assess the prevalence and features of open-angle glaucoma in an urban population in southern India. DESIGN: A population-based cross-sectional study. PARTICIPANTS: A total of 2522 persons (85.4% of those eligible) of all ages, including 1399 persons 30 years of age or older, from 24 clusters representative of the population of Hyderabad city. TESTING: The participants underwent an interview and detailed eye examination that included logarithm of minimum angle of resolution visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, dilatation, cataract grading, and stereoscopic fundus evaluation. Automated Humphrey threshold 24-2 visual fields (Humphrey Instruments Inc., San Leandro, CA) and optic disc photography were performed when indicated by standardized criteria for disc damage or if intraocular pressure (IOP) was 22 mmHg or more. MAIN OUTCOME MEASURES: Definite primary open-angle glaucoma (POAG) was defined as obvious glaucomatous optic disc damage and visual field loss in the presence of an open-angle, and suspected POAG was defined as suspected glaucomatous optic disc damage without definite visual field loss. Ocular hypertension (OHT) was defined as IOP of 22 mmHg or more without glaucomatous optic disc damage or visual field loss in the presence of an open-angle. Glaucomatous optic disc damage or IOP of 22 mmHg or more secondary to an obvious cause and with an open-angle was defined as secondary open-angle glaucoma. RESULTS: Definite POAG, suspected POAG, and OHT were present in 27, 14, and 7 participants, respectively, with age- and gender-adjusted prevalence (95% confidence interval) of 1.62% (0.77%-2.48%), 0.79% (0.39%-1.41%), and 0.32% (0.10%-0.78%) in those 30 years of age or older, and 2.56% (1.22%-3.91%), 1.11% (0.43%-1.78%), and 0.42% (0.11%-1.12%) in those 40 years of age or older, respectively. The prevalence of POAG increased significantly with age using multivariate analysis (P < 0.001). Only two of 27 participants (7.4%) with definite POAG had been previously diagnosed and treated, and 66.7% of the previously undiagnosed had IOP less than 22 mmHg. Fourteen of 27 participants (51.9%) with definite POAG had severe glaucomatous damage based on optic disc and visual field criteria, of which five participants (18.5%) had at least one blind eye as a result of POAG (all with best-corrected distance visual acuity less than 20/400 or central visual field less than 10 degrees); the other 13 participants (48.1%) had moderate glaucomatous damage. Because visual fields and optic disc photography were not performed on all participants, the prevalence of POAG may have been underestimated. Secondary open-angle glaucoma was present in one participant as a result of angle recession. CONCLUSIONS: The prevalence of open-angle glaucoma in this urban population in southern India is at least as much as that reported recently from white populations in developed countries. However, the vast majority of persons with glaucoma were undiagnosed in this population, and a large proportion of those having definite POAG already had severe glaucomatous damage. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/10964833/Open_angle_glaucoma_in_an_urban_population_in_southern_India:_the_Andhra_Pradesh_eye_disease_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(00)00275-X DB - PRIME DP - Unbound Medicine ER -