June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Reasons for presentation with severe glaucoma among patients with newly diagnosed primary glaucoma in a developing world setting
Author Affiliations & Notes
  • Shreyas Ramulu
    River Hill High School, Clarksville, Maryland, United States
  • Annamalai Odayappan
    Aravind Eye Institute Pondicherry, India
  • Srinivasan Kavitha
    Aravind Eye Institute Pondicherry, India
  • Rengaraj Venkatesh
    Aravind Eye Institute Pondicherry, India
  • Footnotes
    Commercial Relationships   Shreyas Ramulu, None; Annamalai Odayappan, None; Srinivasan Kavitha, None; Rengaraj Venkatesh, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3366. doi:
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      Shreyas Ramulu, Annamalai Odayappan, Srinivasan Kavitha, Rengaraj Venkatesh; Reasons for presentation with severe glaucoma among patients with newly diagnosed primary glaucoma in a developing world setting. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3366.

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

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Abstract

Purpose : To identify the reasons why people with a new diagnosis of glaucoma present for care with severe glaucoma damage in a developing world setting.

Methods : Study participants included people who received a new diagnosis of primary glaucoma at the Aravind Eye Institute, Pondicherry, and had not received any (prior) glaucoma treatment. Severe glaucoma was defined as a cup-to-disc ratio of 0.85 or higher, as this level of optic nerve damage, on average, is associated with visual field damage in the moderate to severe range. Reasons for presentation and demographic features were obtained from participants via questionnaire. Logistic regression models were used to identify demographic features and reasons for presentation associated with severe glaucoma at diagnosis.

Results : There were 161 participants in this study. Average age was 60.8 years (SD=11.1) and 62.1% of were male (n=100). Ninety-three participants had mild glaucoma and 67 had severe glaucoma. In univariate analyses, older age (OR: 1.47 per 10 years older, 95% CI: 1.08–1.98, p=0.013) and unemployment (OR: 3.97 vs. employed participants, 95% CI: 2.03–7.76, p < 0.001) were found to be associated with a greater odds of presenting with severe glaucoma. Graduate education, the equivalent of high school completion, (OR: 0.47 vs. below graduate education, 95% CI: 0.24–0.90, p=0.023) and living in an urban area (OR=0.45 vs. living in a rural area, 95% CI: 0.24–0.86, p=0.016) were found to be associated with a lower odds of presenting with severe glaucoma. Among reported reasons for presentation, defective/blurred vision was associated with a higher odds of presenting with severe glaucoma (OR: 2.00, 95% CI: 1.06–3.79, p=0.034). In multivariable models including all significant demographic features and presentation reasons, unemployed participants more likely to present with severe glaucoma as compared to employed participants (OR: 4.19, 95% CI: 1.95–8.99, p<0.001) while living in an urban area was associated with lower odds of severe glaucoma (OR: 0.46, 95% CI: 0.21–0.99, p=0.047).

Conclusions : Unemployed persons and those living in rural areas were particularly likely to be diagnosed with glaucoma at a severe stage of disease. Programs designed to identify undiagnosed glaucoma in developing world settings should devote additional resources to these at-risk populations.

This is a 2020 ARVO Annual Meeting abstract.

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