Abstract
PurposeTo assess the prevalence of glaucoma in rural Central India.MethodsThe population-based Central India Eye and Medical Study is a population-based study performed in a rural region of Central India. The study included 4711 subjects (aged 30+ years). A detailed ophthalmic and medical examination was performed. Glaucoma was defined by glaucomatous optic disc morphology, and in a second step, by the criteria of the International Society of Geographical and Epidemiological Ophthalmology (ISGEO).ResultsOptic disc photographs were available for 4570 (97.0%) subjects. Glaucoma was detected in 122 subjects (51 unilateral) (2.67% (95%CI: 2.20, 3.14). Glaucoma prevalence for the age groups of 30–39yrs, 40–49yrs, 50–59yrs, 60–69yrs, 70–79yrs, and 80+ years was 0.54% (95%CI: 0.11, 0.98), 1.03% (95%CI: 0.49, 1.57), 1.40% (95%CI: 0.58, 2.23), 6.62% (95%CI: 4.92, 8.31), 8.71% (95%CI: 5.55, 11.75), and 14.3% (95%CI: 4.13, 24.4), respectively. In multivariable analysis, glaucoma was associated with higher age (P<0.001), lower body mass index (P = 0.025), lower blood hemoglobin concentration (P = 0.03), higher intraocular pressure (P<0.001), disc hemorrhages (P<0.001), higher prevalence of myopic retinopathy (P<0.001), lower level of education (P = 0.03), longer axial length (P<0.001), thinner retinal nerve fiber layer (P<0.001), higher vertical cup/disc diameter ratio (P<0.001), and narrow anterior chamber angle (P = 0.02). Ratio of open-angle glaucoma to angle-closure glaucoma was 7.7:1 (1.93% (95%CI: 1.64, 2.22) to 0.24% (95%CI: 0.14, 0.34)). Using the ISGEO criteria, glaucoma prevalence was 2.8% (95%CI: 2.3, 3.3) with a less clear association with older age.ConclusionsGlaucoma prevalence in remote rural Central India is comparable to other regions. Associated factors were older age, lower body mass index, lower blood concentration of hemoglobin, lower level of education, higher intraocular pressure, disc hemorrhage, myopic retinopathy, and longer axial length. The ratio of open-angle glaucoma to angle-closure glaucoma was about 8:1.
Highlights
Knowledge about the prevalence of a disease and the associated factors is instrumental for an improved detection of the disorder and for a better understanding of its pathogenesis
Glaucoma was associated with higher age (P,0.001), lower body mass index (P = 0.025), lower blood hemoglobin concentration (P = 0.03), higher intraocular pressure (P,0.001), disc hemorrhages (P,0.001), higher prevalence of myopic retinopathy (P,0.001), lower level of education (P = 0.03), longer axial length (P,0.001), thinner retinal nerve fiber layer (P,0.001), higher vertical cup/disc diameter ratio (P,0.001), and narrow anterior chamber angle (P = 0.02)
Glaucoma prevalence in remote rural Central India is comparable to other regions
Summary
Knowledge about the prevalence of a disease and the associated factors is instrumental for an improved detection of the disorder and for a better understanding of its pathogenesis. Factors associated with the development of glaucoma or with its further progression have been examined in several population-based studies and in numerous large hospital-based investigations [1,2,3,4,5,6], such as Ocular Hypertension Treatment Study [3], the Advanced Glaucoma Intervention Study [4], the Collaborative Initial Glaucoma Treatment Study [5], the Early Manifest Glaucoma Trial [6], and others These studies suggested that high intraocular pressure, low blood pressure, low ocular perfusion pressure, narrow anterior chamber angles, thin corneas, pseudoexfoliation, a low body mass index, and myopia were some of the factors associated with glaucoma. We carried out our study in a remote rural region with a relatively low degree of technical development to get information on the prevalence of glaucoma and its associate factors at a stage before industrialization started
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