The prevalence of primary angle closure glaucoma in European derived populations: A systematic review

UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK
The British journal of ophthalmology (Impact Factor: 2.98). 05/2012; 96(9):1162-7. DOI: 10.1136/bjophthalmol-2011-301189
Source: PubMed

ABSTRACT To estimate the prevalence of primary angle closure glaucoma (PACG) in European derived populations.
Systematic review and modelling of PACG prevalence data from population studies. PACG was defined according to the ISGEO definition requiring structural and/or functional evidence of glaucomatous optic neuropathy. Prevalence estimates were applied to the 2010 United Nations projected population figures to estimate case numbers.
The prevalence of PACG in those 40 years or more is 0.4% (95% CI 0.3% to 0.5%). Age-specific prevalence values are 0.02% (CI 0.00 to 0.08) for those 40-49 years, 0.60% (0.27 to 1.00) for those 50-59 years, 0.20% (0.06 to 0.42) for those 60-69 years and 0.94% (0.63 to 1.35) for those 70 years and older. Three-quarters of all cases occur in female subjects (3.25 female to 1 male; CI 1.76 to 5.94).
This analysis provides a current evidence-based estimate of PACG prevalence in European derived populations and suggests there are 130 000 people in the UK, 1.60 million people in Europe and 581 000 people in the USA with PACG today. Accounting for ageing population structures, cases are predicted to increase by 19% in the UK, 9% in Europe and 18% in the USA within the next decade. PACG is more common than previously thought, and all primary glaucoma cases should be considered to be PACG until the anterior chamber angle is shown to be open on gonioscopy.

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Available from: Alex C Day, Mar 01, 2015
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    • "South East Asia (0.66%), and India (0.46%). A recent systematic review found that the prevalence of PACG in those 40 years or more in European derived populations is 0.4% (95% CI 0.3% to 0.5%) [53]. Therefore, the prevalence of PACG in Asians, especially in East Asians and South East Asians, is higher than those in Europeans. "
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    ABSTRACT: Background Primary angle closure glaucoma (PACG) is higher in Asians than Europeans and Africans, with over 80% of PACG worldwide in Asia. Previous estimates of PACG were based largely on early studies, mostly using inappropriate case definitions. Therefore, we did a systematic review and meta-analysis to estimate the prevalence of PACG in adult Asian populations and to quantify its association with age, gender, and region. Methods All primary reports of population-based studies that reported the prevalence of PACG in adult Asian populations were identified. PACG case definition was compatible with the ISGEO definition. Twenty-nine population-based studies were included. The overall pooled prevalence estimates were calculated using a random effect model, and ethnicity-, age- and gender-specific pooled prevalence estimates were also calculated. Results The overall pooled prevalence of PACG in those of adult Asians was 0.75% (95% CI, 0.58, 0.96). Ethnicity-specific pooled prevalence estimates were 0.97% (0.22, 4.27) in Middle East group, 0.66% (0.23, 1.86) in South East Asia group, 0.46% (0.32, 0.64) in India group, 1.10% (0.85, 1.44) in China group, and 1.19% (0.35, 3.98) in Japan group, respectively. Age-specific prevalence was 0.21% (0.12, 0.37) for those 40–49 years, 0.54% (0.34, 0.85) for those 50–59 years, 1.26% (0.93, 1.71) for those 60–69 years, and 2.32% (1.74, 3.08) for those 70 years or above. The overall female to male ratio of the PACG prevalence was 1.51∶1 (95% CI 1.01, 2.28). Conclusions PACG affects approximately 0.75% adult Asians, increasing double per decade, and 60% of cases being female. The prevalence rates vary greatly by ethnic region.
    PLoS ONE 07/2014; 9(7):e103222. DOI:10.1371/journal.pone.0103222 · 3.23 Impact Factor
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    • "Exacerbation of chronic glaucoma or acute glaucoma during HD sessions is occasionally observed.2–4 Primary angle-closure glaucoma results from a combination of predisposing anterior segment anatomy and unfavorable physiological behavior.5 Currently, it is defined as an occludable angle associated with trabecular meshwork damage/dysfunction (typically raised intraocular pressure [IOP] or presence of peripheral anterior synechiae) and structural and/or functional evidence of glaucomatous optic neuropathy.6 "
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    ABSTRACT: Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD) because of anterior chamber depth changes during this therapy. To evaluate anterior chamber depth and axial length in patients during HD sessions. A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. There was no difference in the axial length between the three measurements (P = 0.241). We observed a significantly decreased anterior chamber depth (P = 0.002) during HD sessions. Our results support the idea that there is a change in anterior chamber depth in HD sessions.
    Clinical ophthalmology (Auckland, N.Z.) 08/2013; 7:1635-9. DOI:10.2147/OPTH.S45952
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    • "Power calculations were undertaken to determine if the current cohorts were sufficiently powered to detect genetic association with the disease at α = 0.05 level assuming complete linkage disequilibrium between the disease causing variant and the marker, in both cohorts. The overall prevalence of PACG is estimated to be 0.4% in European derived populations [24] and 0.43% in Nepalese population. [25] The power varies between SNPs and cohorts due to differences in the allele frequencies in each population and the size of each cohort. "
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    ABSTRACT: A recent large genome-wide association study (GWAS) identified multiple variants associated with primary angle-closure glaucoma (PACG). The present study investigated the role of these variants in two cohorts with PACG recruited from Australia and Nepal. Patients with PACG and appropriate controls were recruited from eye clinics in Australia (n = 232 cases and n = 288 controls) and Nepal (n = 106 cases and 204 controls). Single nucleotide polymorphisms (SNPs) rs3753841 (COL11A1), rs1015213 (located between PCMTD1 and ST18), rs11024102 (PLEKHA7), and rs3788317 (TXNRD2) were selected and genotyped on the Sequenom. Analyses were conducted using PLINK and METAL. After adjustment for age and sex, SNP rs3753841 was found to be significantly associated with PACG in the Australian cohort (p = 0.017; OR = 1.34). SNPs rs1015213 (p = 0.014; OR 2.35) and rs11024102 (p = 0.039; OR 1.43) were significantly associated with the disease development in the Nepalese cohort. None of these SNPs survived Bonferroni correction (p = 0.05/4 = 0.013). However, in the combined analysis, of both cohorts, rs3753841 and rs1015213 showed significant association with p-values of 0.009 and 0.004, respectively both surviving Bonferroni correction. SNP rs11024102 showed suggestive association with PACG (p-value 0.035) and no association was found with rs3788317. The present results support the initial GWAS findings, and confirm the SNP's contribution to PACG. This is the first study to investigate these loci in both Australian Caucasian and Nepalese populations.
    PLoS ONE 06/2013; 8(6):e67903. DOI:10.1371/journal.pone.0067903 · 3.23 Impact Factor
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