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Naomi Odell, Mark Slabaugh, Leona Ding; The Estimated Impact of Changing Refractive Errors on the Future Rates of Angle-closure and Open Angle Glaucoma in Asia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3509.
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Recent research has estimated the future worldwide burden of disease from open angle glaucoma (OAG) and angle closure glaucoma (ACG) at year 2020 to be significantly greater than now. Unrelated studies indicate major shifts in refractive error of certain populations, such as those in Asia, towards higher rates of myopia and high myopia. As myopia, and particularly long axial length, is a known risk factor for open angle glaucoma and protective against narrow angle glaucoma, we hypothesize that the shift in refractive error will likely have an impact on future rates of OAG and ACG.
Review of the existing literature on changes in rates of myopia in local, national, and worldwide populations was obtained and the most representative data extracted. A model was then created for converting amount of myopia to its biometric component of axial length. This biometric surrogate was then used to estimate the change in future rates of open-angle and angle-closure glaucoma.
We estimate that rates of angle closure glaucoma in Asia alone may be decreased by 20-40% if the current trend of increasing myopia is sustained. This would lead to a decreased burden of disease in approximately 6-8 million individuals by 2040. The risk of open angle glaucoma would be significantly increased over this same time period to affect an additional 8-10 million individuals above current estimates.
Estimates of future glaucoma disease burden, particularly in Asia, are likely to be significantly impacted by the concomitant development of large populations with increased axial length. There may be a higher prevalence of OAG, and a lower prevalence of ACG, respectively, than presently appreciated.
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