Prevalence ratio of primary angle-closure glaucoma and primary open-angle glaucoma in Asian population: a meta-analysis and multiple meta-regression

Abstract

Purpose : To investigate the prevalence ratio of primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in Asian population

Methods : Systematic searches of PubMed, EMBASE, and Cochrane databases for population-based studies in Asia published until August 5, 2022. We conducted a meta-analysis for PACG-to-POAG prevalence ratio using inverse-variance-weighted random-effects meta-analyses so as to combine the study-specific measures of association. Between-study outcome variation (i.e., heterogeneity) was quantified with the I² statistic. The multiple meta-regression analyses were performed in order to further account for the reasons for heterogeneity.

Results : Twenty (20) studies, with a total study population of 52,522 individuals, had been conducted in 13 countries. The pooled PACG-to-POAG prevalence ratio was 2.204 (95% CI, 1.617-3.004) with high heterogeneity (I² = 100%, P < 0.001).

The subgroup analysis according to prevalence of POAG (ie, <2.0% vs. ≥ 2.0%) showed relatively higher PACG-to-POAG prevalence ratio for ≥ 2.0% (3.00; 95% CI 2.106-4.270) compared with <2.0% (1.39; 95% CI, 0.930-2.075), with statistical significance (Q = 7.96, P < 0.001). However, the PACG-to-POAG prevalence ratio between studies did not reflect any statistical significance among subgroups by number of study population, baseline mean age, continents, and publication year (all P > 0.01).

In multiple meta-regression model, prevalence of POAG is the most important predictor for heterogeneity (model importance = 0.954), followed continent (0.508) and publication year (0.222). For every additional elevation of POAG prevalence (i.e., increase of 1.0%), the PACG-to-POAG prevalence ratio is expected to rise by 0.471.

No publication bias was evident in this visual examination of plot symmetry. Likewise, there was no evidence of publication bias by the Egger test (P = 0.321).

Conclusions : We estimated the pooled PACG-to-POAG prevalence ratio in Asian population. The POAG prevalence is the most important factor to determine the PACG-to-POAG prevalence ratio.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

 

Forest plot of PACG-to-POAG prevalence ratio in Asian population. The diamond denotes the pooled ratio, and the lateral tips of the diamond indicate the associated CIs.