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Changing views on open-angle glaucoma: definitions and prevalences--The Rotterdam Study.
Invest Ophthalmol Vis Sci 2000; 41(11):3309-21IO

Abstract

PURPOSE

To create a quantitative basis for diagnostic criteria for open-angle glaucoma (OAG), to propose an epidemiologic definition for OAG based on these, and to determine the prevalence of OAG in a general white population.

METHODS

Of the 7983 subjects 55 years of age or older participating in the population-based Rotterdam Study, 6756 subjects participated in the ophthalmic part of this study (6281 subjects living independently and 475 in nursing homes). The criteria for the diagnosis of OAG were based on ophthalmoscopic and semiautomated Imagenet estimations of the optic disc such as vertical cup-to-disc ratio (VCDR), minimal width of neural rim, or asymmetry in VCDR between both eyes, and visual field testing with kinetic Goldmann perimetry. All criteria for the diagnosis of OAG were assessed in a masked way independently of each other.

RESULTS

Mean VCDR on ophthalmoscopy was 0.3 and with Imagenet 0.49, and the 97.5th percentile for both was 0.7. The prevalence of glaucomatous visual field defects was 1.5%. Overall prevalence of definite OAG in the independently living subjects was 0.8% (95% confidence interval [CI] 0.6, 1.0; 50 cases). Prevalence of OAG in men was double that in women (odds ratio 2.1; 95% CI 1.2, 3.6). Different commonly used criteria for diagnosis of OAG resulted in prevalence figures ranging from 0.1% to 1.2%.

CONCLUSIONS

The overall prevalence of OAG in the present study was comparable to most population-based studies. However, prevalence figures differed by a factor of 12 when their criteria for OAG were applied to this population. A definition for definite OAG is proposed: a glaucomatous optic neuropathy in eyes with open angles in the absence of history or signs of secondary glaucoma characterized by glaucomatous changes based on the 97.5 percentile for this population together with glaucomatous visual field loss. In the absence of the latter or of a visual field test, it is proposed to speak of probable OAG based on the 99.5th or possible OAG based on the 97.5th percentiles of glaucomatous disc changes for a population under study.

Authors+Show Affiliations

Departments of Epidemiology and Biostatistics and. Ophthalmology, Erasmus University Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

11006219

Citation

Wolfs, R C., et al. "Changing Views On Open-angle Glaucoma: Definitions and prevalences--The Rotterdam Study." Investigative Ophthalmology & Visual Science, vol. 41, no. 11, 2000, pp. 3309-21.
Wolfs RC, Borger PH, Ramrattan RS, et al. Changing views on open-angle glaucoma: definitions and prevalences--The Rotterdam Study. Invest Ophthalmol Vis Sci. 2000;41(11):3309-21.
Wolfs, R. C., Borger, P. H., Ramrattan, R. S., Klaver, C. C., Hulsman, C. A., Hofman, A., ... de Jong, P. T. (2000). Changing views on open-angle glaucoma: definitions and prevalences--The Rotterdam Study. Investigative Ophthalmology & Visual Science, 41(11), pp. 3309-21.
Wolfs RC, et al. Changing Views On Open-angle Glaucoma: Definitions and prevalences--The Rotterdam Study. Invest Ophthalmol Vis Sci. 2000;41(11):3309-21. PubMed PMID: 11006219.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changing views on open-angle glaucoma: definitions and prevalences--The Rotterdam Study. AU - Wolfs,R C, AU - Borger,P H, AU - Ramrattan,R S, AU - Klaver,C C, AU - Hulsman,C A, AU - Hofman,A, AU - Vingerling,J R, AU - Hitchings,R A, AU - de Jong,P T, PY - 2000/9/28/pubmed PY - 2000/10/14/medline PY - 2000/9/28/entrez SP - 3309 EP - 21 JF - Investigative ophthalmology & visual science JO - Invest. Ophthalmol. Vis. Sci. VL - 41 IS - 11 N2 - PURPOSE: To create a quantitative basis for diagnostic criteria for open-angle glaucoma (OAG), to propose an epidemiologic definition for OAG based on these, and to determine the prevalence of OAG in a general white population. METHODS: Of the 7983 subjects 55 years of age or older participating in the population-based Rotterdam Study, 6756 subjects participated in the ophthalmic part of this study (6281 subjects living independently and 475 in nursing homes). The criteria for the diagnosis of OAG were based on ophthalmoscopic and semiautomated Imagenet estimations of the optic disc such as vertical cup-to-disc ratio (VCDR), minimal width of neural rim, or asymmetry in VCDR between both eyes, and visual field testing with kinetic Goldmann perimetry. All criteria for the diagnosis of OAG were assessed in a masked way independently of each other. RESULTS: Mean VCDR on ophthalmoscopy was 0.3 and with Imagenet 0.49, and the 97.5th percentile for both was 0.7. The prevalence of glaucomatous visual field defects was 1.5%. Overall prevalence of definite OAG in the independently living subjects was 0.8% (95% confidence interval [CI] 0.6, 1.0; 50 cases). Prevalence of OAG in men was double that in women (odds ratio 2.1; 95% CI 1.2, 3.6). Different commonly used criteria for diagnosis of OAG resulted in prevalence figures ranging from 0.1% to 1.2%. CONCLUSIONS: The overall prevalence of OAG in the present study was comparable to most population-based studies. However, prevalence figures differed by a factor of 12 when their criteria for OAG were applied to this population. A definition for definite OAG is proposed: a glaucomatous optic neuropathy in eyes with open angles in the absence of history or signs of secondary glaucoma characterized by glaucomatous changes based on the 97.5 percentile for this population together with glaucomatous visual field loss. In the absence of the latter or of a visual field test, it is proposed to speak of probable OAG based on the 99.5th or possible OAG based on the 97.5th percentiles of glaucomatous disc changes for a population under study. SN - 0146-0404 UR - https://www.unboundmedicine.com/medline/citation/11006219/Changing_views_on_open_angle_glaucoma:_definitions_and_prevalences__The_Rotterdam_Study_ L2 - http://iovs.arvojournals.org/article.aspx?volume=41&page=3309 DB - PRIME DP - Unbound Medicine ER -