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N. K. Wride, A. T. Broman, B. Dineen, Z. Jadoon, A. Khan, D. Khan, G. J. Johnson, C. Gilbert, R. R. A. Bourne; Applying a Method of Estimating the Rate of Progressive Visual Field Damage From Open Angle Glaucoma From Cross Sectional Data Obtained From the National Pakistan Blindness and Visual Impairment Survey. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3984.
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To estimate the incidence of glaucoma and the rate of visual field progression in subjects with open angle glaucoma (OAG), using data from the nationally representative population-based survey of eye disease in Pakistan, the National Pakistan Blindness and Visual Impairment Survey.
Data were obtained from this cross-sectional, nationally representative sample of adults (n=16,507; 95% response rate) aged 30 years and older. Each subject underwent: interview, visual acuity (logMAR), autorefraction and undilated optic disc examination. 1:5 of consecutive subjects aged ≥40 years (a ‘normative database’, n=1868), those that saw <6/12 in either eye, and those with an undilated cup/disc ratio of ≥0.7 underwent a comprehensive examination that included corrected visual acuity, perimetry, Goldmann tonometry, dilated posterior segment examination. The measure of severity of OAG damage was classified by the Mean Deviation (MD) of an automated visual field test (Humphrey Field Analyzer; Carl Zeiss Meditec, Inc., Dublin, CA). The rate of progression was the mean of all subjects’ damage in the worse eye divided by the average time since onset.
51 (26%) of 196 subjects with OAG contributed visual field data. The incidence of OAG in the age groups 30-39 years, 40-49 years, 50-59 years, and 60-69 years was 0.006% (95% confidence interval, CI: 0.003-0.010), 0.006% (0.001-0.012%), 0.009% (0.001-0.016%), 0.010% (0.000-0.021%), respectively. The mean worsening in decibels per year was -3.775 db/yr.
This is the first nationally-representative population-based study to report on incidence of glaucoma and the first in Pakistan. A high progression rate was reported among subjects diagnosed with glaucoma, most probably due to the high proportion of subjects (58%) with glaucoma that were blind in the worse eye at the time of examination. These findings confirm the importance of detection of glaucoma in this population.
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