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Primary open-angle glaucoma in a population associated with high prevalence of primary angle-closure glaucoma: the Kumejima Study.
Ophthalmology 2014; 121(8):1558-65O

Abstract

PURPOSE

To evaluate the prevalence of and risk factors for primary open-angle glaucoma (POAG) in a rural population of southwestern Japan.

DESIGN

Population-based cross-sectional study.

PARTICIPANTS

All residents 40 years of age and older in Kumejima, Okinawa, Japan.

METHODS

Of the eligible 4632 residents 40 years of age and older, 3762 subjects (participant rate, 81.2%) underwent screening examinations, including visual acuity (VA) measurement, slit-lamp examination, Goldmann applanation tonometry, gonioscopy, undilated stereoscopic fundus photographs, autorefractometry, noncontact specular microscopy, pachymetry, and visual field (VF) testing using frequency-doubling technology. If glaucoma or other related ocular disorders were suspected, subjects were referred for definitive examinations including VF testing with the Humphrey Field Analyzer. The diagnosis of POAG was based on the criteria of the International Society for Geographical and Epidemiological Ophthalmology.

MAIN OUTCOME MEASURES

Prevalence and risk factors of POAG.

RESULTS

The prevalence of POAG was 4.0% (95% confidence interval [CI], 3.4%-4.7%); 82% of patients had an intraocular pressure (IOP) less than 22 mmHg, resulting in a prevalence of 3.3% (95% CI, 2.8%-3.9%). Because of POAG, 3 subjects had a VA worse than 20/400 in only 1 eye, and 1 subject had VA loss of worse than 20/400 bilaterally. The average IOP values (mean ± standard deviation) were 14.9 ± 3.2 and 14.6 ± 3.3 mmHg in the right and left eyes, respectively; the IOP values were higher in patients with POAG (15.4 ± 3.3 and 15.2 ± 3.3 mmHg, respectively) than in subjects without glaucoma (14.8 ± 3.1 and 14.4 ± 3.1 mmHg, respectively; P<0.045, Student t test). Multivariate analysis showed that male gender (P = 0.003), older age (P<0.001), higher IOP (P<0.001), longer axial length (P<0.001), and thinner central cornea (P = 0.006) were associated with POAG.

CONCLUSIONS

High prevalence rates of POAG (4.0%) and POAG with normal IOP levels (3.3%), which were comparable with those on the Japanese mainland, were found in a southwestern rural island of Japan, where the prevalence of primary angle-closure glaucoma (previously reported as 2.2%) was considerably higher than on the Japanese mainland (0.6% in the Tajimi Study) or other countries. The risk factors for POAG included male gender, older age, higher IOP, myopia, and a thinner cornea.

Authors+Show Affiliations

Department of Ophthalmology, University of the Ryukyus, Graduate School of Medicine, Okinawa, Japan.Department of Ophthalmology, University of the Ryukyus, Graduate School of Medicine, Okinawa, Japan. Electronic address: sshoichi@med.u-ryukyu.ac.jp.Department of Ophthalmology, Tajimi Iwase Eye Clinic, Gifu, Japan.Department of Ophthalmology, University of Gifu Graduate School of Medicine, Gifu, Japan.Department of Ophthalmology, Niigata University, Graduate School of Medicine, Niigata, Japan.Department of Ophthalmology, Toho University Graduate School of Medicine, Tokyo, Japan.Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan; Kanto Central Hospital of The Mutual Aid Association of Public School Teachers, Tokyo, Japan.

Pub Type(s)

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

Language

eng

PubMed ID

24746386

Citation

Yamamoto, Shunichi, et al. "Primary Open-angle Glaucoma in a Population Associated With High Prevalence of Primary Angle-closure Glaucoma: the Kumejima Study." Ophthalmology, vol. 121, no. 8, 2014, pp. 1558-65.
Yamamoto S, Sawaguchi S, Iwase A, et al. Primary open-angle glaucoma in a population associated with high prevalence of primary angle-closure glaucoma: the Kumejima Study. Ophthalmology. 2014;121(8):1558-65.
Yamamoto, S., Sawaguchi, S., Iwase, A., Yamamoto, T., Abe, H., Tomita, G., ... Araie, M. (2014). Primary open-angle glaucoma in a population associated with high prevalence of primary angle-closure glaucoma: the Kumejima Study. Ophthalmology, 121(8), pp. 1558-65. doi:10.1016/j.ophtha.2014.03.003.
Yamamoto S, et al. Primary Open-angle Glaucoma in a Population Associated With High Prevalence of Primary Angle-closure Glaucoma: the Kumejima Study. Ophthalmology. 2014;121(8):1558-65. PubMed PMID: 24746386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary open-angle glaucoma in a population associated with high prevalence of primary angle-closure glaucoma: the Kumejima Study. AU - Yamamoto,Shunichi, AU - Sawaguchi,Shoichi, AU - Iwase,Aiko, AU - Yamamoto,Tetsuya, AU - Abe,Haruki, AU - Tomita,Goji, AU - Tomidokoro,Atsuo, AU - Araie,Makoto, Y1 - 2014/04/18/ PY - 2013/07/04/received PY - 2014/03/03/revised PY - 2014/03/04/accepted PY - 2014/4/22/entrez PY - 2014/4/22/pubmed PY - 2014/12/15/medline SP - 1558 EP - 65 JF - Ophthalmology JO - Ophthalmology VL - 121 IS - 8 N2 - PURPOSE: To evaluate the prevalence of and risk factors for primary open-angle glaucoma (POAG) in a rural population of southwestern Japan. DESIGN: Population-based cross-sectional study. PARTICIPANTS: All residents 40 years of age and older in Kumejima, Okinawa, Japan. METHODS: Of the eligible 4632 residents 40 years of age and older, 3762 subjects (participant rate, 81.2%) underwent screening examinations, including visual acuity (VA) measurement, slit-lamp examination, Goldmann applanation tonometry, gonioscopy, undilated stereoscopic fundus photographs, autorefractometry, noncontact specular microscopy, pachymetry, and visual field (VF) testing using frequency-doubling technology. If glaucoma or other related ocular disorders were suspected, subjects were referred for definitive examinations including VF testing with the Humphrey Field Analyzer. The diagnosis of POAG was based on the criteria of the International Society for Geographical and Epidemiological Ophthalmology. MAIN OUTCOME MEASURES: Prevalence and risk factors of POAG. RESULTS: The prevalence of POAG was 4.0% (95% confidence interval [CI], 3.4%-4.7%); 82% of patients had an intraocular pressure (IOP) less than 22 mmHg, resulting in a prevalence of 3.3% (95% CI, 2.8%-3.9%). Because of POAG, 3 subjects had a VA worse than 20/400 in only 1 eye, and 1 subject had VA loss of worse than 20/400 bilaterally. The average IOP values (mean ± standard deviation) were 14.9 ± 3.2 and 14.6 ± 3.3 mmHg in the right and left eyes, respectively; the IOP values were higher in patients with POAG (15.4 ± 3.3 and 15.2 ± 3.3 mmHg, respectively) than in subjects without glaucoma (14.8 ± 3.1 and 14.4 ± 3.1 mmHg, respectively; P<0.045, Student t test). Multivariate analysis showed that male gender (P = 0.003), older age (P<0.001), higher IOP (P<0.001), longer axial length (P<0.001), and thinner central cornea (P = 0.006) were associated with POAG. CONCLUSIONS: High prevalence rates of POAG (4.0%) and POAG with normal IOP levels (3.3%), which were comparable with those on the Japanese mainland, were found in a southwestern rural island of Japan, where the prevalence of primary angle-closure glaucoma (previously reported as 2.2%) was considerably higher than on the Japanese mainland (0.6% in the Tajimi Study) or other countries. The risk factors for POAG included male gender, older age, higher IOP, myopia, and a thinner cornea. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/24746386/Primary_open_angle_glaucoma_in_a_population_associated_with_high_prevalence_of_primary_angle_closure_glaucoma:_the_Kumejima_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(14)00201-2 DB - PRIME DP - Unbound Medicine ER -