Abstract
Purpose :
Although determinants of undiagnosed/diagnosed POAG have been studied in several population-based studies, there is a paucity of such information on PACG, a leading cause of glaucoma-related blindness in Asia. The Kumejima study revealed high prevalence rates of both POAG of 4.0% ( Yamamoto et al. Ophthalmology 2014;121:1558-1565) and PACG of 2.2% (Sawaguchi et al. Ophthalmology 2012;119:1134-42) in Kumejima and provided an unique opportunity to compare determinants of undiagnosed/diagnosed glaucoma between PACG and POAG in the same region.
Methods :
In the Kumejima Study, 82 (28 previously diagnosed and 54 undiagnosed cases) cases were diagnosed as definite PACG and 151 cases (26 previously diagnosed and 125 undiagnosed cases) were diagnosed as definite POAG according to the criteria of International Society of Geographical and Epidemiological Ophthalmology. Systemic and ocular factors were compared between diagnosed and undiagnosed PACG or POAG cases, and multivariate logistic regression analysis was used to identify determinants significantly relating to the undiagnosed/diagnosed glaucoma after adjustment for other confounding factors.
Results :
The ratio of undiagnosed glaucoma was 65.9% for PACG and 82.7% for POAG (P=0.003). Univariate logistic regression analysis showed 4 (2) out of systemic factors, 5 (5) out of 16 ocular factors, 3 (5) out of visual function-related factors, and 3 (3) out of fundus planimetric factors showed P ≤ 0.10 between diagnosed and undiagnosed PACG (POAG) groups which were taken into multivariate logistic regression analysis. It indicated that worse mean deviation (MD) value (P<0.001), history of acute angle closure (P=0.055) and absence of smoking history (P=0.005) significantly related to diagnosis of PACG, while worse pattern standard deviation and MD values (P=0.023, 0.076), history of other ocular diseases (P=0.012) and greater vertical cup/disc ratio (PP<0.001) related to diagnosis of POAG.
Conclusions :
The ratio of undiagnosed glaucoma was lower for PACG than POAG. Evaluation by eye doctors including visual field (VF) and slit-lamp examination and history taking about smoking history was thought to be useful in finding PACG, while evaluation by eye doctors including VF and fundus examination were thought to be useful in finding POAG.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.