Purchase this article with an account.
P. J. Harasymowycz, Y. Buys, R. Gaspo, K. Kwok, D. Zhou, T. Nguyen; Glaucoma Disease Significantly Related to Severity at Time of Diagnosis and Associated Risk Factors. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2767.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
It has previously been shown that the cost for treating glaucoma increases with disease severity. This study was designed to describe the severity of OAG at time of diagnosis in Canadian patients and to compare glaucoma risk factors by disease severity.
This was a cross-sectional, non-interventional study. Eligible subjects with newly diagnosed and previously untreated OAG underwent a complete medical history and ocular examination. Disease severity was determined according to optic disc and VF characteristics as previously published by Damji et al (CJO 2003;38:189-97). Descriptive statistics of all variables for OAG were calculated. In order to assess which risk factors and/or ocular variables were associated with OAG severity, adjusted odds ratios (OR), along with 95% confidence intervals (CIs), were obtained from multiple logistic regression models in which a comparison between advanced OAG vs. early or moderate OAG was performed.
A total of 292 subjects with OAG were included: majority had primary OAG (69.2%). Other diagnoses included normal tension (22.3%), pseudoexfoliation (5.5%) and pigmentary glaucoma (3.1%). Overall, 51.7% of subjects had early, 27.1% had moderate and 20.9% had advanced OAG at time of diagnosis. The results of multiple logistic regression found that the odds ratios for advanced vs. early or moderate OAG for findings not associated with stage of disease included 5.17 (95% CI: 1.27-21.10, p=0.022) for disc pallor, 2.66 for presence of peripapillary atrophy (95% CI: 1.51-4.69; p=0.001), 2.60 (95% CI: 1.30-5.19, p=0.007) for presence of NFLD, 2.08 for localized notch or rim thinning (95% CI: 1.12-3.86; p=0.021), and 1.89 for presence of smoking (95% CI: 1.05-3.41; p=0.034).
Almost half of the subjects with OAG presented with moderate or advanced disease at the time of diagnosis. Evaluation of the various risk factors found optic disc pallor, peripapillary atrophy, presence of a NFLD, localized notch or rim thinning and smoking to be significant.
This PDF is available to Subscribers Only