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


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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    • "Even though primary angle-closure glaucoma (PACG) is less prevalent than open-angle glaucoma, PACG may cause blindness in a higher proportion of patients with this eye disease (Foster et al., 2000). PACG occurs in about 0.5% of whites and blacks over the age of 40 (Buhrmann et al., 2000; Day et al., 2012; Mitchell, Smith, Attebo, & Healey, 1996; Rotchford, Kirwan, Muller, Johnson, & Roux, 2003; Tielsch et al., 1991), and occurs in about 0.5–1.5% of Chinese and Indian individuals in the same age group (He et al., 2006; Liang et al., 2011; Dandona et al., 2000). Of all glaucoma cases in China, 35% suffer from PACG, and 90% of patients blinded by glaucoma have PACG (Foster & Johnson, 2001). "
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    ABSTRACT: Glaucoma is a chronic optic neuropathy characterized by progressive damage to the optic nerve, death of retinal ganglion cells and ultimately visual field loss. It is one of the leading causes of irreversible loss of vision worldwide. The most important trigger of glaucomatous damage is elevated eye pressure, and the current standard approach in glaucoma therapy is reduction of intraocular pressure (IOP). However, despite the use of effective medications or surgical treatment leading to lowering of IOP, progression of glaucomatous changes and loss of vision among patients with glaucoma is common. Therefore, it is critical to prevent vision loss through additional treatment. To implement such treatment(s), it is imperative to identify pathophysiological changes in glaucoma and develop therapeutic methods taking into account neuroprotection. Currently, there is no method of neuroprotection with long-term proven effectiveness in the treatment of glaucoma. Among the most promising molecules shown to protect the retina and optic nerve are neurotrophic factors. Thus, the current focus is on the development of safe and non-invasive methods for the long-term elevation of the intraocular level of neurotrophins through advanced gene therapy and topical eye treatment and on the search for selective agonists of neurotrophin receptors affording more efficient neuroprotection.
    Full-text · Article · Dec 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.
    Full-text · Article · Jul 2014 · PLoS ONE
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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.
    Full-text · Article · Aug 2013 · Clinical ophthalmology (Auckland, N.Z.)
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