Abstract
Purpose::
To evaluate the distribution of glaucoma patients and preferences of anti-glaucoma drug usage in Japanese common clinics.
Methods::
A cross-sectional observational study was conducted. A total of 4119 eyes from 2176 cases who visited the 33 clinics and 44 doctors in the Kyoto and Shiga districts from January 1st to February 28th, 2006 were enrolled. The intraocular pressure (IOP), visual field (VF), glaucoma type (primary open angle glaucoma (POAG); normal tension glaucoma with high teen IOP (NTG_hi); NTG with low teen IOP (NTG_lo); ocular hypertension (OHT); other types of glaucoma (Others)), age, and drug usage of each patient were recorded and analyzed. All doctors were asked to self-declare their subspecialty and were then divided into two groups, glaucoma specialists (G group) and general ophthalmologists (non-G group). Glaucoma drug preference was compared in each glaucoma type, stage, and physician’s subspecialty.
Results::
The distribution of each glaucoma type was 1474, 636, 476, 556, and 878 eyes in POAG, NTG_hi, NTG_lo, OHT, and Others, respectively. That of glaucoma stage was 2244, 870, and 466 eyes for early, intermediate, and end-stage, respectively. The most preferred anti-glaucoma drugs were PGs. Those patients who received more than three glaucoma drugs were 36.9% and the rate increased as the stages progressed. The proportion of drug-free patients was 9.9% in POAG, more than 25% in NTG and OHT, and 33.8% in Others. The mean IOP was kept low in the following order, NTG_lo, NTG_hi, POAG, Others, and OHT. As for the physician’s subspecialty, more patients with end-stage glaucoma visited the G group (9 clinics, 12 doctors) than the non-G group (26 clinics, 32 patients); 18.8 vs. 9.5%, respectively. Only the mean IOP of NTG_lo in the G group was significantly lower than that in the non-G, while others showed no differences between the two groups.
Conclusions::
The distribution of glaucoma patients in this study showed a strong cooperation among the clinics. Except for the NTG_lo patients, there were few differences between the G and non-G groups in the preference of glaucoma therapy.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials