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P. Mitchell, A.J. Lee, E. Rochtchina, E.–M. Chia, P.R. Healey, J. Wang, Blue Mountains Eye Study; 10–Year Incidence and Progression of Open–Angle Glaucoma in an Older Population: The Blue Mountains Eye Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2342.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the 5– and 10–year incidence of open–angle glaucoma in an older population.
The Blue Mountains EyeStudy is a population–based cohort study that examined 3654 persons at baseline (82% of those eligible), 2335 after 5 years (BMES2: 75% of survivors) and 1952 (BMES3: 76% of survivors) after 10 years. 2461 participants had data available from BMES2 or 3. Glaucoma was diagnosed at all three examinations from presence of matching optic disc cupping with neuro–retinal rim thinning (graded from stereo–photographs) plus typical glaucomatous visual field defects (assessed from Humphrey 30–2 fields), after gonioscopy. Incident glaucoma was classified as definite or probable; the latter category included subjects with some incomplete data. Glaucoma incidence was calculated using Kaplan–Meier methods. Discrete logistic models were used to assess the risk of incident glaucoma according to various baseline factors, including age, gender, family history and a number of postulated ocular and systemic parameters.
82 definite (n=66) or probable (n=16) cases of incident glaucoma over the period were identified, 4.5% (95%CI 3.5–5.5), and involved both eyes in 27%. Glaucoma incidence was higher in women (5.6%) than men (3.0%), and increased makedly by age (2.0%, 3.7%, 10.3% of persons aged <60 years, 60–69 and 70+ years at baseline(, after adjusting for sex. The following factors were significant baseline predictors of incident glaucoma in in age–sex adjusted and multivariate models: age (per 10–yr), relative risk, RR, 2.1 (95% CI 1.6–2.8); female gender, RR 2.1 (CI 1.3–3.6); family history, RR 2.2 (1.2–3.9), blood pressure (mean arterial– per 10 mm), RR 1.28 (CI 1.07–1.43), ocular hypertension, RR 7.2 (CI 4.2–12.4), IOP (per mm icrease), RR 1.27 (CI 1.19–1.36), presence of beta–PPA, RR 1.7 (CI 1.0–2.8), cup–disc ratio (per 0.1, adjusted for disc size), RR 2.4 (CI 2.0–2.9) or cup–disc ratio >0.5, RR 5.7 (CI 3.6–9.0) and disc haemorrhage, RR 9.9 (CI 3.8–25.7). Reduced central corneal thickness (lowest qunitile of measurements; 418–510 microns) also predicted incident glaucoma, RR 2.0 (CI 1.2–3.4). Diabetes, migraine, thyroid disease, myopia and pseudoexfoliation were not significant predictors of incident glaucoma. Risk factors for glaucoma progression will be summarised.
This study has establised the long–term incidence of open–angle glaucoma, together with many systemic and ocular predictors, in an older population. These data may be used to validate glaucoma risk calculators developed from clinic–based series.
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