July 2019
Volume 60, Issue 9
ARVO Annual Meeting Abstract  |   July 2019
Population-based comparison of determinants of undiagnosed/diagnosed primary angle closure glaucoma (PACG) and open-angle glaucoma (POAG) in the same region
Author Affiliations & Notes
  • Makoto Araie
    Ophthalmology, Kanto Central Hospital, Mutual Aid Association of Public School Teachers, Setagaya-Ku, TOKYO, Japan
  • Hiroshi Sakai
    Ophthalmology, Graduate School of Medicine ,University of the Ryukyus, Japan
  • Makoto Fujii
    Health Science, Osaka University Graduate School of Medicine, Suita, Japan
  • Aiko Iwase
    Ophthalmology, Tajimi Iwase Eye Clinic, Japan
  • Footnotes
    Commercial Relationships   Makoto Araie, Aerie (C), Alcon (F), Heidelberg Engineering (F), Kowa (C), Kowa (F), Otsuka (F), Pfizer (C), Santen (F), Senju (C), Senju (F), Topcon Medical System (C), Topcon Medical System (F), Topcon Medical System (P); Hiroshi Sakai, Alcon (F), Novartis (F), Otsuka (F), Pfizer (F), Santen (F), Senju (F); Makoto Fujii, None; Aiko Iwase, Alcon (F), Carl Zeiss Meditec (F), Heidelberg Engineering (F), Kowa (F), Otsuka (F), Pfizer (F), Santen (C), Santen (F), Senju (F), Topcon (F), Topcon (P)
  • Footnotes
    Support  the Ministry of Health Labor and Welfare, Tokyo,Japan( No 27015A); the Ministry of Education, Culture, Sports, Science and Technology, Tokyo, Japan(No 17591845) ; the Fund from the Japan National Societry for the Prevention of Blindness, Tokyo, Japan
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1970. doi:
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      Makoto Araie, Hiroshi Sakai, Makoto Fujii, Aiko Iwase; Population-based comparison of determinants of undiagnosed/diagnosed primary angle closure glaucoma (PACG) and open-angle glaucoma (POAG) in the same region. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1970.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.


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