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S.D. Smith, I. Al-Jadaan, M.H. Jabak, A. Al-Rajhi, A. Al-Saif; The Prevalance of Glaucoma in a Population-Based Sample of Elderly Saudis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3172.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the prevalence of glaucoma by mechanistic subtype in a population-based sample of elderly Saudis, age 60 years and older. Methods: A population-based sample of 785 Saudi citizens age 60 years and older was selected from a census maintained through community health centers near Al-Kharj, Saudia Arabia. Comprehensive ophthalmic examination was performed for each subject, including gonioscopy. Patients in whom suspicion of glaucoma was present were sent for visual field testing with the Dicon LD400 40 point threshold-related suprathreshold screening exam with quantification of missed points. Final classification of glaucoma status was made by two trained glaucoma specialists. Each reviewed the results of the clinical examination and visual field testing, and classified subjects as normal, possible, probable, or definite glaucoma. For purposes of classification, glaucoma was defined as the presence of glaucomatous optic nerve damage with visual field loss. The level of IOP was not a criterion for the diagnosis of glaucoma. In addition to assigning a category of diagnostic certainty, the glaucoma experts assigned a glaucoma mechanism for each eye. Disagreements in classification were reconciled by joint review of study charts when necessary. Results: A total of 565 (72.0%) subjects agreed to participate. Each decade of increasing age was associated with an odds ratio for having probable or definite glaucoma of 1.49 (95% CI [1.05, 2.12], p=0.03). The median IOP of subjects with glaucoma was 27 mmHg, compared to 17 mmHg among the remaining subjects (p=0.0001) The most common glaucoma subtypes were primary narrow-angle and primary open-angle glaucoma, with prevalence of 3.9% (95% CI [2.5,5.8]) and 3.7% (95% CI [2.3,5.6]), respectively. Among subjects without probable or definite glaucoma, the presence of occludable angles 19.0% (95% CI[15.6,22.7]). Conclusions: In this population, primary narrow-angle glaucoma is common, with prevalence approaching that reported in east Asian populations. Primary open-angle is also common, with prevalence intermediate to that reported in other racial groups of comparable age. The high prevalence of primary narrow-angle glaucoma and occludable angles in Saudi Arabia indicates the need to develop effective methods of population-based screening and prevention in that region.
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