Angle closure glaucoma in rural and urban populations in eastern India—The Hooghly River Glaucoma Study

Abstract

Purpose:To estimate the prevalence, features, and associations of primary angle closure disease (PACD) in rural and urban populations from West Bengal in eastern India.Methods:This was a population-based cross-sectional study with two arms, rural and urban. The rural study area consisted of 28 contiguous villages from 13 gram panchayats in Balagarh Police Station, with rural base hospital at Dhobapara, Balagarh Police Station, in the village Kuliapara of Hooghly district. A tertiary eye hospital in central Kolkata was the urban study center. Individuals residing in the study area aged 40 years and above were included in this study using multistage random cluster sampling. All subjects underwent a detailed ophthalmic examination at our base hospitals including applanation tonometry, ultrasound pachymetry, gonioscopy, and frequency doubling technology perimetry. Data collected were analyzed using SPSS 13. Multiple logistic regressions were used to analyze risk factors for PACD.Results:A total of 7,408 and 7,248 subjects aged 40 years or older were enumerated from Hooghly district and Kolkata city, respectively. PACD was detected in 1.9% subjects in rural arm and 1.54% subjects in the urban arm (P < 0.001). In rural arm, 0.3% had PACS, 0.56% had PAC, and 1.03% had PACG. In urban arm, 0.22% had PACS, 0.35% had PAC, and 0.97% had PACG.Conclusion:The study concludes that higher age, higher CCT, and shorter axial length/presence of hyperopia are important independent predictors of ACD. ACD is more common in eastern India than previous estimates.

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“…However, research in India has shown that the risk of developing closed glaucoma is higher in rural populations, while those patients with DM may have a higher risk of developing glaucoma. No statistical relationship has been established between air pollution and blood pressure disorders [ 32 ]. In urban areas, the open-angle glaucoma had a high prevalence due to the higher prevalence of myopia in these areas [ 33 ].…”

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“… 1 PACG is predominantly asymptomatic in the Asian population 2 and >90% of the cases go undiagnosed, making it difficult to study the true prevalence. 3 The relative lack of health-care resources in some of these countries is another factor contributing to its underestimation.…”

“… 4 Kurita et al showed that central AC depth (ACD) is a better predictor of primary angle closure than AC angle or AC volume. 5 Multiple studies have confirmed central ACD as a good surrogate marker for development of angle-closure disease, 3–5 making it an ideal parameter that can be used as a screening tool.…”

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