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Awareness of incident open-angle glaucoma in a population study: the Barbados Eye Studies.
Ophthalmology 2007; 114(10):1816-21O

Abstract

PURPOSE

To evaluate factors related to awareness of incident open-angle glaucoma (OAG) in the Barbados Eye Studies.

DESIGN

Cohort study with 81% to 85% response rate over 9 years.

PARTICIPANTS

Four thousand three hundred fourteen participants of African descent, 40 to 84 years old at baseline.

METHODS

Standardized study visits included an interview on demographic, medical, health care, and other factors; various ophthalmic measurements; fundus photography; and comprehensive ophthalmologic examinations for those referred.

MAIN OUTCOME MEASURES

Definite OAG was defined by both visual field and optic disc criteria after ophthalmologic confirmation, regardless of intraocular pressure (IOP). Definite incident participants without prior OAG diagnosis/treatment were considered unaware. Logistic regression analyses evaluated factors associated with OAG unawareness. Results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS

Over 9 years, 125 participants newly developed definite OAG, of whom 53% were previously unaware. At baseline, the unaware group had significantly lower mean IOP (OR, 0.86; 95% CI, 0.79-0.94) and more hyperopia (OR, 2.69; 95% CI, 1.08-6.69) than those aware. Most unaware and aware participants had > or =2 medical care visits in the previous year (72.7% vs. 83.1%). However, those in the unaware group sought eye care less frequently than those aware (last visit in preceding year, 33.4% vs. 64.4%); these visits were mainly for eyeglasses (71.4% vs. 12.5%), with most having glaucoma tests only during study visits (72.7% vs. 37.3%). The unaware group reported more visits to opticians/optometrists than to private ophthalmologists (OR, 4.20; 95% CI, 1.00-17.66) and fewer visits to a public ophthalmologic clinic (OR, 0.18; 95% CI, 0.04-0.86).

CONCLUSIONS

Over half of participants with incident OAG were unaware of their diagnosis. Unawareness was related to lower IOP, hyperopia, and eye care utilization patterns. Although persons in the unaware group had regular visits for medical care, visits for eye care and OAG testing were limited. Unawareness was 4 times more likely when opticians/optometrists were the regular eye care source, compared with private ophthalmologists, and about 80% less likely with a public ophthalmologic source. These findings highlight the high frequency of undiagnosed OAG and importance of comprehensive examinations in disease detection.

Authors+Show Affiliations

Chronic Disease Research Centre, Tropical Medicine Research Institute, University of the West Indies, Bridgetown, Barbados.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17698198

Citation

Hennis, Anselm, et al. "Awareness of Incident Open-angle Glaucoma in a Population Study: the Barbados Eye Studies." Ophthalmology, vol. 114, no. 10, 2007, pp. 1816-21.
Hennis A, Wu SY, Nemesure B, et al. Awareness of incident open-angle glaucoma in a population study: the Barbados Eye Studies. Ophthalmology. 2007;114(10):1816-21.
Hennis, A., Wu, S. Y., Nemesure, B., Honkanen, R., & Leske, M. C. (2007). Awareness of incident open-angle glaucoma in a population study: the Barbados Eye Studies. Ophthalmology, 114(10), pp. 1816-21.
Hennis A, et al. Awareness of Incident Open-angle Glaucoma in a Population Study: the Barbados Eye Studies. Ophthalmology. 2007;114(10):1816-21. PubMed PMID: 17698198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Awareness of incident open-angle glaucoma in a population study: the Barbados Eye Studies. AU - Hennis,Anselm, AU - Wu,Suh-Yuh, AU - Nemesure,Barbara, AU - Honkanen,Robert, AU - Leske,M Cristina, AU - ,, Y1 - 2007/08/15/ PY - 2006/08/23/received PY - 2007/06/05/revised PY - 2007/06/05/accepted PY - 2007/8/19/pubmed PY - 2007/10/19/medline PY - 2007/8/19/entrez SP - 1816 EP - 21 JF - Ophthalmology JO - Ophthalmology VL - 114 IS - 10 N2 - PURPOSE: To evaluate factors related to awareness of incident open-angle glaucoma (OAG) in the Barbados Eye Studies. DESIGN: Cohort study with 81% to 85% response rate over 9 years. PARTICIPANTS: Four thousand three hundred fourteen participants of African descent, 40 to 84 years old at baseline. METHODS: Standardized study visits included an interview on demographic, medical, health care, and other factors; various ophthalmic measurements; fundus photography; and comprehensive ophthalmologic examinations for those referred. MAIN OUTCOME MEASURES: Definite OAG was defined by both visual field and optic disc criteria after ophthalmologic confirmation, regardless of intraocular pressure (IOP). Definite incident participants without prior OAG diagnosis/treatment were considered unaware. Logistic regression analyses evaluated factors associated with OAG unawareness. Results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Over 9 years, 125 participants newly developed definite OAG, of whom 53% were previously unaware. At baseline, the unaware group had significantly lower mean IOP (OR, 0.86; 95% CI, 0.79-0.94) and more hyperopia (OR, 2.69; 95% CI, 1.08-6.69) than those aware. Most unaware and aware participants had > or =2 medical care visits in the previous year (72.7% vs. 83.1%). However, those in the unaware group sought eye care less frequently than those aware (last visit in preceding year, 33.4% vs. 64.4%); these visits were mainly for eyeglasses (71.4% vs. 12.5%), with most having glaucoma tests only during study visits (72.7% vs. 37.3%). The unaware group reported more visits to opticians/optometrists than to private ophthalmologists (OR, 4.20; 95% CI, 1.00-17.66) and fewer visits to a public ophthalmologic clinic (OR, 0.18; 95% CI, 0.04-0.86). CONCLUSIONS: Over half of participants with incident OAG were unaware of their diagnosis. Unawareness was related to lower IOP, hyperopia, and eye care utilization patterns. Although persons in the unaware group had regular visits for medical care, visits for eye care and OAG testing were limited. Unawareness was 4 times more likely when opticians/optometrists were the regular eye care source, compared with private ophthalmologists, and about 80% less likely with a public ophthalmologic source. These findings highlight the high frequency of undiagnosed OAG and importance of comprehensive examinations in disease detection. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/17698198/Awareness_of_incident_open_angle_glaucoma_in_a_population_study:_the_Barbados_Eye_Studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)00664-1 DB - PRIME DP - Unbound Medicine ER -