Yahya Shaikh1, Fei Yu2, Anne L Coleman3. 1. General Preventive Medicine Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 2. Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California. 3. Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California. Electronic address: colemana@ucla.edu.
Abstract
PURPOSE: To determine the burden of undetected and untreated glaucoma in the noninstitutionalized population over the age of 40 years in the United States of America (US). DESIGN: Cross-sectional study. METHODS: setting: US civilian, noninstitutionalized population from the 2005-2006 and 2007-2008 administrations of the National Health and Nutrition Examination Survey that were 40 years old or older with completed retinal photographs, completed interview question regarding prior diagnosis of glaucoma, and a negative response to questions regarding comorbidities. main outcome measures: Prevalence of self-reported glaucoma history; signs of glaucoma damage seen in retinal photographs and perimetry; prevalence of undiagnosed glaucoma; and comparison of demographic factors using odds ratios to identify populations with highest burden of previously undiagnosed glaucoma. RESULTS: The study population included 3850 participants who met the inclusion criteria. The 99.5th percentile of the vertical cup-to-disc ratio was 0.67 and the 99.5th percentile of the vertical cup-to-disc ratio asymmetry between eyes was 0.26. Prevalence of undiagnosed glaucoma was 2.9%, increasing with age to 6.6% of the population over 70 years old. Among those with glaucoma, 78% were previously undiagnosed and untreated. Blacks have roughly 4.4 times (95% confidence interval [CI]: 2.9-6.7; P < .0001) and Hispanics have roughly 2.5 times (95%CI: 1.5-4.3; P = .0012) greater odds of having undiagnosed and untreated glaucoma than non-Hispanic whites. CONCLUSIONS: Approximately 2.4 million persons in the US have undetected and untreated glaucoma. Overall, prevalence of both diagnosed and undiagnosed glaucoma is much higher in minorities and the elderly. Among those with definite glaucoma, individuals younger than 60 years of age have a greater proportion of undetected disease.
PURPOSE: To determine the burden of undetected and untreated glaucoma in the noninstitutionalized population over the age of 40 years in the United States of America (US). DESIGN: Cross-sectional study. METHODS: setting: US civilian, noninstitutionalized population from the 2005-2006 and 2007-2008 administrations of the National Health and Nutrition Examination Survey that were 40 years old or older with completed retinal photographs, completed interview question regarding prior diagnosis of glaucoma, and a negative response to questions regarding comorbidities. main outcome measures: Prevalence of self-reported glaucoma history; signs of glaucoma damage seen in retinal photographs and perimetry; prevalence of undiagnosed glaucoma; and comparison of demographic factors using odds ratios to identify populations with highest burden of previously undiagnosed glaucoma. RESULTS: The study population included 3850 participants who met the inclusion criteria. The 99.5th percentile of the vertical cup-to-disc ratio was 0.67 and the 99.5th percentile of the vertical cup-to-disc ratio asymmetry between eyes was 0.26. Prevalence of undiagnosed glaucoma was 2.9%, increasing with age to 6.6% of the population over 70 years old. Among those with glaucoma, 78% were previously undiagnosed and untreated. Blacks have roughly 4.4 times (95% confidence interval [CI]: 2.9-6.7; P < .0001) and Hispanics have roughly 2.5 times (95%CI: 1.5-4.3; P = .0012) greater odds of having undiagnosed and untreated glaucoma than non-Hispanic whites. CONCLUSIONS: Approximately 2.4 million persons in the US have undetected and untreated glaucoma. Overall, prevalence of both diagnosed and undiagnosed glaucoma is much higher in minorities and the elderly. Among those with definite glaucoma, individuals younger than 60 years of age have a greater proportion of undetected disease.
Authors: Lauren K Wareham; Ana C Dordea; Grigorij Schleifer; Vincent Yao; Annabelle Batten; Fei Fei; Joseph Mertz; Meredith Gregory-Ksander; Louis R Pasquale; Emmanuel S Buys; Rebecca M Sappington Journal: Neurobiol Dis Date: 2018-09-10 Impact factor: 5.996
Authors: Sarah E Miller; Suman Thapa; Alan L Robin; Leslie M Niziol; Pradeep Y Ramulu; Maria A Woodward; Indira Paudyal; Ian Pitha; Tyson N Kim; Paula Anne Newman-Casey Journal: Am J Ophthalmol Date: 2017-07-19 Impact factor: 5.258