Abstract
Abstract: :
Purpose: To evaluate prospectively the age of the patients at diagnosis in patients with Primary Open Angle Glaucoma (POAG) in comparison to Normal Tension Glaucoma (NTG), Pigmentary Glaucoma (PG), Ocular Hypertension (OH), Primary Angle Closure Glaucoma (PACG) and Pseudoexfoliation Glaucoma (PEX). To evaluate the relative frequency of glaucoma detection in seven age groups and the mean age at diagnosis in four stages of visual field loss (VFL) in these glaucomas. This may allow some conclusions on differences in the onset of the diseases, on the time dynamic of visual field progression, on the impact risk factor IOP and may allow to judge the time frame between beginning VFL and blindness in untreated glaucomas. Methods: According to the eye with the more severe VFL we categorised 4 stage groups (I-IV):I. No VFL, II. beginning VFL (stage I and II,classification of Aulhorn),III. moderate VFL (stage III and IV)and IV. severe VFL (stage V). The maximum intraocular pressure (IOP) was used for evaluation. Age at the time of diagnosis was available in 1275 eyes/patients with POAG, 147 with NTG, 49 with PG, 133 with OH, 65 with PEX and 221 with PACG. Results: POAG: Mean age at diagnosis: 54,81 ± 12,56 years. Stage group I: 52,36 ± 12,93, II: 55,98 ± 11,30, III: 57,76 ± 11,75, IV: 60,32 ± 12,07 years (p = 0,0001 ANOVA-test). IOP max: I: 27,80 ± 4,51,II: 28,39 ± 5,37, III: 28,53 ± 5,73 IV: 32,60 ± 9,45 mmHg.The difference in the mean time of diagnosis between stage group I and IV was 8 years for POAG, 10 for NTG, 6 for PG, 3 for PEX, 3 for PACG. This is in accordance with the hight of IOP. There is a significant difference in the mean time of diagnosis between POAG and NTG (57,23 ± 13,43; p = 0,0262), PG (43,76 ± 13,02; p < 0,0001), OH (51,08 ± 12,01; p = 0,0011), PEX (65,45 ± 7,87; p < 0,0001), but not in PACG (51,32 ± 13,4 years; p = 0,1609). Age distribution of diagnosis in POAG in age groups: up to 30 years: 3,6 %, between 31 - 40 years: 9,1 %, 41 - 50 y.: 22,2 %, 51 - 60 y.: 31,7 %, 61 - 70 y.: 24,6 %, 71 - 80 y.: 7,8 %, more than 80 years: 0,9 %. Distribution differs between glaucomas. Conclusion: In POAG, age of the patients at the time of diagnosis, age of the patient, IOP max influences visual field progression. The differences in the age at diagnosis between glaucomas suggests differences in the onset of the disease. These differences are significant for an effective glaucoma screening.