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Prevalence of glaucoma

Näytönastekatsaus | Julkaistu: 28.03.2023 Tulosta
Glaucoma Working Group

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

  1. Hollands H, Johnson D, Hollands S ym. Do findings on routine examination identify patients at risk for primary open-angle glaucoma? The rational clinical examination systematic review. JAMA 2013;309:2035-42 «PMID: 23677315»PubMed
  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
  3. Sommer A, Tielsch JM, Katz J ym. Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans. The Baltimore Eye Survey. Arch Ophthalmol 1991;109:1090-5 «PMID: 1867550»PubMed
  4. Bonomi L, Marchini G, Marraffa M ym. Prevalence of glaucoma and intraocular pressure distribution in a defined population. The Egna-Neumarkt Study. Ophthalmology 1998;105:209-15 «PMID: 9479277»PubMed
  5. Mitchell P, Smith W, Attebo K ym. Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study. Ophthalmology 1996;103:1661-9 «PMID: 8874440»PubMed
  6. Wolfs RC, Borger PH, Ramrattan RS ym. Changing views on open-angle glaucoma: definitions and prevalences--The Rotterdam Study. Invest Ophthalmol Vis Sci 2000;41:3309-21 «PMID: 11006219»PubMed
  7. Armaly MF, Krueger DE, Maunder L ym. Biostatistical analysis of the collaborative glaucoma study. I. Summary report of the risk factors for glaucomatous visual-field defects. Arch Ophthalmol 1980;98:2163-71 «PMID: 7447768»PubMed
  8. Georgopoulos G, Andreanos D, Liokis N ym. Risk factors in ocular hypertension. Eur J Ophthalmol 1997;7:357-63 «PMID: 9457459»PubMed
  9. Gordon MO, Kass MA. The Ocular Hypertension Treatment Study: design and baseline description of the participants. Arch Ophthalmol 1999;117:573-83 «PMID: 10326953»PubMed
  10. Kass MA, Heuer DK, Higginbotham EJ ym. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 2002;120:701-13; discussion 829-30 «PMID: 12049574»PubMed
  11. Hirvelä H, Tuulonen A, Laatikainen L. Intraocular pressure and prevalence of glaucoma in elderly people in Finland: a population-based study. Int Ophthalmol 1994;18:299-307 «PMID: 7607812»PubMed
  12. Topouzis F, Wilson MR, Harris A ym. Prevalence of open-angle glaucoma in Greece: the Thessaloniki Eye Study. Am J Ophthalmol 2007;144:511-9 «PMID: 17893012»PubMed
  13. Karvonen E, Stoor K, Luodonpää M ym. Prevalence of glaucoma in the Northern Finland Birth Cohort Eye Study. Acta Ophthalmol 2019;97:200-207 «PMID: 30198084»PubMed
  14. McCann P, Hogg R, Wright DM ym. Glaucoma in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): cohort profile, prevalence, awareness and associations. Br J Ophthalmol 2020;104:1492-1499 «PMID: 32034006»PubMed
Article ID: nak09688 (037.030)
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