Evaluation of risk factors for advanced glaucoma in Ghanaian patients

Abstract

Purpose This study was to determine factors associated with individuals presenting late with advanced glaucomatous optic nerve damage. Methods A case-control study recruiting 123 patients with early features of primary open angle glaucoma (control) and 93 patients with advanced glaucoma (cases) was carried out for risk-factor analysis. Exposures of interest included those already established as major risk factors for glaucoma. These were initial intraocular pressure (IOP), age, and family history. In addition, occupation, ethnic origin, history of diagnosis of diabetes mellitus, hypertension, sickle cell disease, and previous eye examination were of interest. Results Univariate analysis showed that initial IOP431 mmHg, age of 4 60 years, absence of family history of glaucoma, occupational grouping, ethnicity, and male sex were associated with advanced glaucoma at presentation. Adjusted odds ratio or by multiple logistic regression model showed that initial IOP431 mmHg in a patient was more likely to present with advanced glaucoma (OR 2.66, 95% confidence interval (CI) 1.45, 4.91; P-value 0.0017) than lower pressures. Patients aged 60-69 years (OR 2.53, 95% CI 1.01, 6.31; P-value 0.0473) and 70-90 years (OR 5.16, 95% CI 1.97, 13.51; P-value 0.0008) were more likely to present with advanced glaucoma than younger ones Conclusions Subjects with initial IOP431 mmHg were nearly three times more likely to present with advanced glaucoma than those with IOPo32 mmHg. Subjects over the age of 60 years were more than two times likely to present with advanced glaucoma than younger subjects.

A Study of Central Corneal Thickness in Glaucoma and Nonglaucoma Patients in a West African Population

“…9,10 High IOP is a major risk factor for glaucoma. [11][12][13] Although IOP is an essential indicator in diagnosing, evaluation, and monitoring the management of glaucoma, studies have pointed to potential sources of error in measurement. 14,15 Our study found that glaucoma cases had thinner corneas (OD = 519.84-528.72 mm; OS = 520.22-529.18 mm) than controls (OD = 525.44-534.56 mm; OS = 526.66-535.46 mm).…”

Glaucoma awareness, knowledge, perception of risk and eye screening behaviour among residents of Abokobi, Ghana

“…Because there are also no overt symptoms or associated pain, people do not undergo screening, a requirement for early diagnosis [12]. This results in a high proportion of patients presenting advanced stages of the disease where there is loss of sight in an eye or both eyes [25] Most Africans, present either unilateral or bilateral blindness of glaucoma due to late detection of the disease [25, 27]. Furthermore, African countries are highly underserved in terms of eye care services, with about a million people to one ophthalmologist [12, 28, 29].…”

The effect of medical therapy on IOP control in Ghana

“…12 Ntim-Amponsah et al investigated risk factors for glaucoma progression and reported that initial IOP>31 mmHg was associated with advanced glaucoma at presentation, but also did not investigate the effects of medical treatment. 13 The poor measure of control among study subjects in this study is unlikely to be a result of low efficacy of the various medications used to reduce IOP. The effectiveness of the most commonly used drugs have been extensively studied and used in the major glaucoma clinical trials with good outcomes in reducing IOP.…”