Skip to main content

  • Risk Factors for Undetected POAG

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
    Add to My Bookmarks

    Journal Highlights

    British Journal of Ophthalmology
    Published online June 25, 2021

    Download PDF

    Chan et al. looked at data from the European Prospective Investigation of Cancer (EPIC)-Norfolk Eye Study to explore possible links between undiag­nosed primary open-angle glaucoma (POAG) and ocular, socioeconomic, and other factors. They found that overreliance on pretreatment intraocular pressure (IOP) hinders the detection of POAG.

    In the EPIC-Norfolk Eye Study, oph­thalmic data were collected for 8,623 patients between 2004 and 2011. For this cross-sectional study, Chan et al. augmented that data with details such as family history of glaucoma, self-reported problems with eyesight and use of corrective lenses, and general health status. They also conducted systematic screenings, including assessments of the optic nerve head and peripapillary nerve fiber layer. Patients with findings suggestive of glaucoma were referred to a glaucoma specialist for further evaluation. Logistic regression was used to analyze risk factors for previously undiagnosed POAG. Factors that were significant in the univariable model were entered into multivariable analyses.

    Among the 8,623 participants, 363 were diagnosed as having glaucoma, including 314 with POAG. Of the POAG cases, 207 had been diagnosed previ­ously, and 107 were newly identified during the study. In the final multivariate model, factors significant for previously undetected glaucoma were lower IOP before treatment and lack of reported eyesight problems. Insignificant factors were age, current em­ployment, visual field mean deviation, pseudophakia, absolute refractive error, cup/disc ratio, glaucoma type, and family history of glaucoma.

    In the United Kingdom, POAG is di­agnosed by opportunistic case finding, which relies on patients presenting to an eye care professional, with subsequent referral to the Hospital Eye Service un­der the National Health Service if glau­coma is suspected. Those at high risk of glaucoma (age >60 years; age >40 years with first-degree family history) can get an optician’s eye test free of charge.

    The most important implication of this research is to “avoid being falsely reassured by a lower level of IOP in glaucoma case finding,” the authors said.

    The original article can be found here.