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Prevalence and risk factors for primary glaucomas in adult urban and rural populations in the Andhra Pradesh Eye Disease Study.

Abstract：

PURPOSE:To compare the prevalence of and risk factors for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) in urban and rural populations in the Andhra Pradesh Eye Disease Study. DESIGN:A population-based, cross-sectional study using a stratified, random, cluster, and systematic sampling strategy. PARTICIPANTS:Between 1996 and 2000, participants from 94 clusters in 1 urban and 3 rural areas representative of the population were included. METHODS:We performed a detailed eye examination, including applanation tonometry, gonioscopy, and dilated fundus evaluation after ruling out risk of angle closure. Humphrey threshold 24-2 visual fields were performed when indicated. MAIN OUTCOME MEASURES:Glaucoma was diagnosed and categorized using International Society of Geographical and Epidemiological Ophthalmology criteria. The prevalence and risk factors for POAG and PACG in subjects aged > or = 40 years were compared between the urban and rural cohorts. RESULTS:There were 3724 subjects > or = 40 years, with 934 in the urban and 2790 in the rural cohort. The prevalence of POAG was greater in the urban compared with the rural cohort (4% vs 1.6%; P<0.001). Age and intraocular pressure (IOP) were risk factors for POAG in both cohorts. Blindness owing to POAG was 11.1% in the rural and 2.7% in the urban cohort. The prevalence of PACG (1.8% vs 0.7%; P<0.01), primary angle closure (PAC) (0.8% vs 0.2%; P = 0.02) and primary angle closure suspect (PACS; 3.5% vs 1.5%; P<0.01) were significantly different between the urban and rural cohorts. Increasing age was a risk factor in the urban cohort. Intraocular pressure was a risk factor in both the populations. Blindness owing to PACG was equal (20%) in both the populations. Female gender was a risk factor in the rural cohort (P = 0.032). CONCLUSIONS:The prevalence of both POAG and PACG was greater in urban than in the rural population. Intraocular pressure was a significant risk factor for both POAG and PACG in both cohorts. Increasing age was a significant risk factor for POAG in both cohorts and for PACG in the urban cohort. Female gender was a risk factor for PACG in the rural cohort. There was more blindness owing to PACG than to POAG. FINANCIAL DISCLOSURE(S):The authors have no proprietary or commercial interest in any of the materials discussed in this article.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Garudadri C,Senthil S,Khanna RC,Sannapaneni K,Rao HB

doi

10.1016/j.ophtha.2009.11.006

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

1352-9

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(09)01294-9

journal_volume

117

pub_type

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Prevalence and risk factors for primary glaucomas in adult urban and rural populations in the Andhra Pradesh Eye Disease Study.