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Aiko Iwase, Yasuaki Kuwayama, Tetsuya Yamamoto, Shoichi Sawaguchi, Makoto Araie; Prevalence and Clinical Associations of 4 Glaucomatous Disc Types in Japanese Open Angle Glaucoma Patients Determined in Population-based Setting. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4272.
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4 disc types in open angle glaucoma (OAG), focal glaucomatous (FG), myopic glaucomatous (MG), general enlargement (GE), senile sclerotic (SS) types, associated with different clinical associations were reported. Prevalence and clinical associations of these 4 disc types have been studied in hospital-based settings, but rarely in less biased population-based settings. The purpose of this study is to report prevalence and clinical associations of the 4 glaucomatous disc types in Japanese OAG patients found in 2 Japanses population-based studies.
In 2 population-based studies in Japan, Tajimi Study (Iwase et al. Ophthalmology, 2004) and Kumejima Study (Sawaguchi et al, Ophthalmology, 2012), a total of 273 patients were diagnosed as having definite OAG according to the same International Society for Geometric and Epidemiological Ophthalmology criteria. Among them, disc photos with 30-degree visual angle with acceptable quality was obtained in 270 patients at least in one eye, which were examined by 4 independent masked investigators (IA, YK, TY, MA). Discs were classified into FG, MG, GE, SS, mixed appearance and unclassifiable and only discs where judgment by the 4 unanimously agreed upon were adopted
Among 270 right eyes examined, 90 (33.3%), 11 (4.1%), 48 (17.8%) and 5 (1.9%) were classified in to FG, MG, GE and SS disc type, respectively. Prevalence of MG and SS type disc was much lower than those reported in hospital-based studies in Japan (e.g., Nakazawa et al. J Glaucoma, 2012). FG type disc was more likely to be previously diagnosed (P=0.039) and smaller disc size (P=0.000); MG type disc was associated with younger age (P=0.036), higher myopic power (P=.000) and larger PPA-beta area (P=0.040); GE type disc was associated with higher prevalence of PPA-beta (P=0.037) . Other systemic or ocular factors including blood pressure, intraocular pressure, central corneal thickness or mean deviation value showed no significant inter-group difference. Analysis of the left eyes yielded essentially the same results.
Prevalence and clinical associations of FG, MG, GE and SS disc types in Japanese OAG patients were described in general population. Prevalence of MG and SS disc type was much lower than those reported in hospital-based studies in Japan. Association of some ocular factors with each glaucomatous disc type was found.
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