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D. E. Grigera, A. Peyret, J. Casiraghi, P. Hernández; A Multicentric, Cross-Sectional Glaucoma Study in Buenos Aires, Argentina. Degree of Damage, Legal Blindness and Glaucoma Diagnoses. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3982.
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© ARVO (1962-2015); The Authors (2016-present)
To assess degree of damage and rate of legal blindness of the different glaucoma diagnoses in outpatients from 4 urban hospitals in Buenos Aires, Argentina.
Cross-sectional study including 1273 adult patients under glaucoma care, assisted between October 2007 and May 2008, who underwent interview and complete glaucoma examination. Data on demographics, glaucoma diagnosis, bilaterality, visual acuity (VA) and visual fields (VF) were uptaken. Legal blindness was defined as corrected VA of 20/200 or less in the better eye, VF constricted to 20 degrees or less, or both.
Average age was 60.56 ± 15 years. 43.68% were male. 143 were glaucoma suspects (11.23%). In patients with confirmed glaucoma the most frequent diagnosis was POAG with 602 patients (47.5%). Other causes: pseudoexfoliation-associated glaucoma (PXEG) in 175 (13.74%), PCAG in 121 (9.50%), neovascular glaucoma (NVG) in 60 (4.71%), acute angle closure in 38 (2.98%), juvenile glaucoma (JG) in 31 (2.43%), inflammatory and congenital in 25 each (1.96%), traumatic in 19 (1.49%), pigmentary in 10 (0.78%), and lens-induced in 2 (0.16 %). Mean oldest age was found in PXEG (70.59 ± 8 ys) Mean youngest in congenital (28.33 ± 13 ys). In acute angle closure patients, 63 (16%) were unilateral, as well as 12 (63, 16%) in traumatic. In the rest of diagnoses bilaterality prevailed. 453 patients had a VA of less than 20/200 in at least one eye (35.61%), and 107 (8.41%) in both. In 25.61% of the eyes with low VA the cause was not glaucomatous. VFs qualified as advanced to non-recordable in one or in both eyes of 413 patients (32.44%). Legal blindness was present in 420 patients (32.99%). 41 patients were legally blind in NVG (68,33% of individuals with this diagnosis), 9 (36%) in inflammatory, 41 (33.8%) in PCAG, 59 (33.71%) in PXEG, 197 (32.72%) in POAG, 5 (26.32%) in traumatic, 9 (23,68%) in acute angle closure, 6 (19.35%) in JG. In comparing rates of legal blindness in each diagnosis with the population as a whole, NVG showed a significant difference (p<0.0001).
This is a severely affected population since one third of the individuals is afflicted by legal blindness. The most frequent diagnosis is POAG, followed by PXEG. NVG and JG show, respectively, the highest and lowest rate of legal blindness. PCAG, PXEG and POAG are, in this area, remarkably similar to the whole sample.
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