Takaisin

Prevalence of glaucoma

Näytönastekatsaukset
Glaucoma Working Group
28.3.2023

Level of evidence: B

Among individuals over the age of 50 years the prevalence of glaucoma is ca 2%, increasing to >3% in the age group over 75 years.

Systematic review 1

Structured Medline (January 1950 – January 2013) search and a hand search of references and citations of retrieved articles yielding 57 articles from 41 studies were included in the systematic review. The summary prevalence of glaucoma in the highest-quality studies was 2.6% (95% CI, 2.1%-3.1%) «Hollands H, Johnson D, Hollands S ym. Do findings ...»1.

Systematic review 2

The systematic review identified 4 383 reports from the search for studies on epidemiology, risk and disease progression, of which 285 were selected for full assessment for this review. 92 reports describing 27 studies met the inclusion criteria for the review. The date of last searches was December 2005.

The overall quality of each study was summarised as (A) no major flaws or (B) possible important flaws. Studies were included when they rated ‘A' in all fields. Exceptions were made to include ‘B' studies when no better evidence was available. In most studies (81%), participants were sampled adequately and selected from a relevant population. Suboptimal approaches to diagnose OAG (e.g., high IOP, absence of a visual test, unstandardised criteria) were used in five studies (19%). IOP status was obtained from a secure record (examination or examination records) in most studies.

In the UK, the estimated prevalence of OAG was 2.1% [95% confidence interval (CI) 1.7 to 2.5], ranging from 0.3% in people aged 40 to 3.3% in people aged 70 years.

The incidence ranged from 30 to 181 per 100 000 person-years for ages 50 years and 70 years, respectively «Burr JM, Mowatt G, Hernández R ym. The clinical ef...»2.

Comment

The reported prevalences are dependent on the definitions of glaucoma as well diagnostic tests and their selected threshold for abnormality which are not agreed upon. E.g., if the diagnosis is based on structure much higher prevalences have been reported in Finland «Hirvelä H, Tuulonen A, Laatikainen L. Intraocular ...»11. The major challenges to evaluate a diagnostic test in glaucoma is the lack of a perfect reference standard. The risk of bias of diagnostic study designs is an additional concern [see also «Effectiveness of diagnostic tests»1, «Variability in structural evaluation»2 and «Variability of visual filed examinations»3].

References

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  2. Burr JM, Mowatt G, Hernández R ym. The clinical effectiveness and cost-effectiveness of screening for open angle glaucoma: a systematic review and economic evaluation. Health Technol Assess 2007;11:iii-iv, ix-x, 1-190 «PMID: 17927922»PubMed
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