Prevalence of Primary Angle Closure Glaucoma in the Last 20 Years: A Meta-Analysis and Systematic Review.

Nan Zhang,Biyue Chen,Jiaxing Wang,Ying Li,Bing Jiang

doi:10.3389/fmed.2020.624179

Abstract

Purpose: This meta-analysis aims to investigate the worldwide prevalence of primary angle-closure glaucoma (PACG) and its risk factors in the last 20 years.Methods: We conducted a systematic review and meta-analysis of 37 population-based studies and 144,354 subjects. PubMed, Embase, and Web of Science databases were searched for cross-sectional or cohort studies published in the last 20 years (2000–2020) that reported the prevalence of PACG. The prevalence of PACG was analyzed according to various risk factors. A random-effects model was used for the meta-analysis.Results: The global pooled prevalence of PACG was 0.6% [95% confidence interval (CI) = 0.5–0.8%] for the last 20 years. The prevalence of PACG increases with age. Men are found less likely to have PACG than women (risk ratio = 0.71, 95% CI = 0.53–0.93, p < 0.01). Asia is found to have the highest prevalence of PACG (0.7%, 95% CI = 0.6–1.0%). The current estimated population with PACG is 17.14 million (95% CI = 14.28–22.85) for people older than 40 years old worldwide, with 12.30 million (95% CI = 10.54–17.57) in Asia. It is estimated that by 2050, the global population with PACG will be 26.26 million, with 18.47 million in Asia.Conclusion: PACG affects more than 17 million people worldwide, especially leading a huge burden to Asia. The prevalence of PACG varies widely across different ages, sex, and population geographic variation. Asian, female sex, and age are risk factors of PACG.

Highlights

Glaucoma is one of the leading causes of irreversible blindness worldwide [1]
Studies published between January 2000 to September 2020 were included in this meta-analysis when they met the following inclusion criteria: [1] Population-based cross-sectional or cohort studies in which the prevalence of primary angle-closure glaucoma (PACG) from a defined geographic region was provided; [2] Studies with a clear definition of random or clustered sampling procedure; [3] PACG defined by using International Society for Geographical and Epidemiological Ophthalmology (ISGEO) [9] criteria or similar to ISGEO that based on structure and/or functional evidence of glaucomatous optic neuropathy with occludable anterior chamber angle; [4] Studies that prevalence data for PACG can be extracted or calculated
We reviewed the full text of 68 studies about PACG prevalence published in the last 20 years, and 31 were excluded based on inclusion and exclusion criteria

Summary

Introduction

Glaucoma is one of the leading causes of irreversible blindness worldwide [1]. PACG has been associated with many risk factors, including ethnicity, age, and sex [6,7,8], and they all contribute to the prevalence. Updates in study designs and diagnostic methods of PACG alter the estimations of prevalence and population, whereas the International Society for Geographical and Epidemiological Ophthalmology (ISGEO) provides a standard PACG definition for survey [9]. With the rapid increase in global population and aging trends, it is critical to pool PACG prevalence and estimate up-to-date and accurate PACG prevalence, providing evidence for a future health-care plan. We aimed to estimate the detailed prevalence of PACG globally in a risk factor-specific manner for the last two decades

Objectives

Methods

Results

Discussion

Conclusion