Prevalence of Unknown Ocular Hypertension, Glaucoma Suspects, and Glaucoma in Patients Seen in an Ophthalmology Center in France

Abstract

Introduction: The rate of unknown glaucoma is around 50% in industrialized countries. The purpose of our study was to estimate the prevalence of unknown cases of ocular hypertension, glaucoma suspects, and glaucoma in patients consulting for refractive disorders in France. Methods: A retrospective study in the Point Vision ophthalmology center was led in Toulouse, France. All participants consulting for refractive disorders between June 2015 and June 2017 in the ophthalmology center were included. The cases were identified by the assessment of intraocular pressure, optic nerve head structure, and visual field. Ocular hypertension was defined as an intraocular pressure > 21 mm Hg. Glaucoma was defined as the association of a glaucomatous papilla and two successive pathological visual fields. Glaucoma suspect was defined as the association of a glaucomatous papilla without visual field defect. The primary endpoint was the prevalence of unknown ocular hypertension, glaucoma suspects, and glaucoma in patients seen in an ophthalmology center. Results: A total of 66,068 patients (mean age = 37 years) consulted for a refraction visual assessment during the study period. Among them, 234 had a visual field and a retinal nerve fiber layer assessment for ocular hypertension and/or suspicious papilla. The prevalence of unknown cases of ocular hypertension, glaucoma suspect, and glaucoma was 2.6, 0.8, and 0.5 per 1,000 consultants, respectively. Median age at diagnosis of ocular hypertension, glaucoma suspect, and glaucoma was 52, 53, and 65 years, respectively. Conclusion: The present study highlights the importance of glaucoma screening in people over 40 years old with the measurement of intraocular pressure and an optic nerve head assessment.

Topical Medication Therapy for Glaucoma and Ocular Hypertension

“…Normal tension glaucoma (NTG) is characterized by a IOP usually below 21 mmHg, while the primary open-angle glaucoma (POAG) has a IOP of over 22 mmHg ( Razeghinejad and Lee, 2019 ), the latter being the main and modifiable risk factor for glaucoma and its progression ( Fogagnolo and Rossetti, 2011 ; Jayaram, 2020 ). Ocular hypertension (OHT) is defined as a IOP over 21 mmHg without the damage of the optic disk and view field ( Chamard et al, 2020 ), but it is most likely to develop into open-angle glaucoma (OAG) ( Kass et al, 2021 ).…”

Agreement of Optic Nerve Head Evaluation of Primary Open-Angle Glaucoma Between General Ophthalmologists and Glaucoma Specialists

“…In the present study, we found that the initial diagnosis rate of POAG was 5.21%, which is higher than the prevalence of POAG described in other population-based studies. [15][16][17][18][19][20][21] The major reason was that participants were recruited among outpatients, which would make the rate higher with a smaller screening population. However, this proved to be a cost-effective way to screen POAG.…”

Clinical Audit on the Effectiveness of Clinic-Based Intraocular Pressure Phasing for Patients With Glaucoma and Glaucoma Suspect

“…A GS is defined as a person who has one or more clinical features and/or risk factors that increase the possibility of developing glaucomatous optic neuropathy and visual deficiency in the future [ 9 , 11 ]. This includes those with elevated IOP, optic nerve head (ONH), or retinal nerve fiber layer (RNFL) appearance suggestive of glaucomatous damage, unexplained visual field (VF) defect consistent with glaucoma, and strong family history of severe glaucoma and other risk factors.…”

“…NTG is an optic nerve neuropathy that presents with optic disk excavation and VF loss despite IOP < 21 mmHg [ 12 ]. OHT is defined as an eye with IOP > 21 mmHg, a normal optic nerve, and a normal visual field [ 11 ]. Clinic hour phasing was conducted for these patients to rule out any fluctuation of IOP, IOP trough and peak, that subsequently ascertains the final diagnosis.…”