Unexpectedly High Prevalence of Glaucoma in Germany: Results from the Gutenberg Health Study

Abstract

Purpose : To determine the prevalence of open-angle glaucoma (OAG) according to the ISGEO classification in an adult European cohort.

Methods : The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in the Rhine-Main Region in mid-western Germany with a total of 15,010 participants. In this study, the first 5,000 subjects with an age range between 35 and 74 years were included. At baseline, participants underwent a standardized protocol with a general cardiovascular and ophthalmic examination, which included slitlamp biomicroscopy, non-contact tonometry, fundus photography, central corneal thickness measurement and visual field testing. Optic disc pictures were obtained by a non-mydriatic fundus camera (Visucam™) and analyzed using the Visupac™ software. The prevalence was determined in two steps. First, the ISGEO classification was applied using “hypernormal subjects” (normal visual function) as reference. In the second analysis, we additionally considered the disc area (DA) dependency of the vertical cup-to-disc ratio by a quantile regression.

Results : The overall prevalence of definite OAG in our sample was 1.6% (n=79). The disc area adjusted prevalence was 1.5% (n=74). The prevalence gradually increased in both models with every age decade (0.8% to 2.4%, respectively). In both models none of the glaucoma cases had a small optic disc (<1.6 mm²). For medium and large optic discs there was a significant prevalence difference, whether disc area was considered or not. The prevalence in medium optic discs was 1.2% vs. 1.8% and in large optic discs 5.7% vs. 2.5%, respectively, applying the non-adjusted vs. the DA adjusted classification.

Conclusions : Prevalence of definite glaucoma was higher than in most other Caucasian population-based cohorts, although our sample was the youngest cohort so far. In addition, our analysis underlined the crucial influence of optic disc size in determining the diagnosis of glaucoma.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.