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Tutul Chakravarti; Profiling Primary Glaucoma in West Bengal: State & NGO Hospitals’ Data. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2595.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma, one of the leading causes of preventable blindness, will soon affect 79.6 million.Glaucoma patients in developing countries are particularly disadvantaged: a higher risk of progressing to blindness-- mostly at advanced stage than in developed nations. Glaucoma data are primarily collected from European and North American studies with limited input from developing world. This study aims to review the clinical profile, distribution of various types of primary glaucoma and its severity at presentation in all subtypes in Wes Bengal.
This observational cross-sectional study of 221 patients in glaucoma clinic of a teaching hospital, a private clinic and a NGO Eye Hospital collected and analysed demographic and clinical data including prior management during 2014-15. Main Outcome measures were age, sex, BCVA, IOP, gonioscopy, optic disc and visual field evaluation. Diurnal variation of IOP was observed.Patients were categorized by ISGEO and EGS guidelines.Glaucoma staging was done by visual field: 0-3,following Hodapp’s classifications; patients with field of vision<10 at end stage.
Primary angle closure glaucoma was the most common subtype,73 (33%);next, primary open angle glaucoma, 65 (29%).Other common subtypes were normal tension glaucoma,41(19%) and juvenile open angle glaucoma,19 (9%).Male dominance was seen for POAG (71%); GS (80%); JOAG (68%), NTG (73%) and OHT (60%); female dominance for primary angle closure suspect, 86%; primary angle closure, 83% and 56% in PACG. The mean age at presentation was POAG: 60±10.5,PACG: 56±9.6 and for NTG: 61±10(p<0.001).Rising number of end stage glaucoma at presentation was seen in all subtypes: 36% in POAG and NTG, 50% in PACG, and 68.4% in JOAG (p<0.001).Mean of SAP MD for JOAG was -21.3 dB±11.6,for OAG -15.1dB±10.5 & for PACG -14.4dB±11.6 (p<0.001).Unilateral blindness due to PACG was 29% while bilateral blindness was maximum in POAG 6% and JOAG,5%.
The pattern of glaucoma varies in different regions of India. Previous studies reported NTG being relatively rare, JOAG least reported in North India and PACG being less prevalent in West Bengal.Our result indicates greater occurrence of NTG than previously thought; PACG maximum with unilateral blindness. All subtypes (especially PACG & JOAG) had advanced glaucoma at presentation. However, the prevalence of PACG varies in different surveys due to methodology and age of the patients studied.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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