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C. S. Garudadri, S. Senthil, R. C. Kanna, K. Sannapaneni; Prevalence and Risk Factors for Primary Open Angle Glaucoma and Primary Angle Closure Disease in Urban and Rural Populations in Andhra Pradesh Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5051.
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To compare the prevalence and risk factors for Primary Open Angle Glaucoma and Primary angle closure disease in urban and rural populations in Andhra Pradesh Eye Disease Study
A population-based study using a stratified, random, cluster, systematic sampling strategy, was conducted in the state of Andhra Pradesh in India during 1996 to 2000. Participants from 94 clusters in one urban and 3 rural areas representative of the population of Andhra Pradesh underwent a comprehensive ocular evaluation that included logarithm of minimum angle of resolution visual acuity, refraction, split lamp biomicroscopy, applanation tonometry and gonioscopy. Gonioscopy was performed with NMR-K 2 mirror gonio lens under appropriate testing conditions to define occludability before manipulating gonioscopy to visualize the angle structures. All participants underwent pupilary dilatation and detailed fundus evaluation except those with occludable angles. Humphrey full threshold 24-2 visual fields were performed when indicated by standardized criteria for disc cupping or if intraocular pressure was more than or equal to 22 mm of Hg. Trained professionals performed all examinations. Glaucoma was diagnosed using International Society of Geographical and Epidemiological Ophthalmology classification
POAG was present in 37/934 in urban (4%) as compared to 45/2790 (1.6%) in rural area. Blindness due to POAG was more (P=0.02) in rural (33.3%) as compared to urban cohort (10.8%). Age (P <0.001) and IOP (P<0.001) were risk factors for POAG in both urban and rural cohorts, but not diabetes, hypertension, socio economic status and myopia. Prevalence of PACG in urban 15/934 (1.8%) was more (P=0.002) than PACG 20/2790 (0.6%) in rural cohort. Prevalence of PAC in urban 7/934(0.8%) was more (P= 0.02) than PAC 5/2790 (0.2%) in rural cohort. Prevalence of PACS in urban 30/934(3.5%) was more (P<0.001) than PACS 41/2790 (1.5%) in rural cohort. Blindness due to PACG was comparable (P=0.8) in urban (26.7%) with rural (23.5%) cohort. Female gender was not a risk factor for angle closure disease in either the urban (P=0.69) or rural cohort (P=0.6). Diabetes was a risk factor for angle closure disease in urban (P=0.04) but not in rural cohort (P=0.38). Hyperopia was a risk factor in rural (P=0.02) but not in urban cohort
The prevalence of both POAG and primary angle closure disease in population 40 years old or more was greater in urban as compared to rural area. Blindness due to POAG was more in rural area while blindness due to PACG was similar in both the areas
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