Results of the Bhaktapur Glaucoma Study, Nepal

Abstract

I nt r oduction: The Bhaktapur Glaucoma Study is a population-based, cross-sectional and longitudinal study undertaken in one of the districts of Nepal. Objectives: To determine the prevalence of glaucoma in Bhaktapur district, Nepal. Materials and methods: Thirty clusters were randomly selected and a door-to-door census was conducted to identify citizens 40 years of age and older. Four thousand eight hundred individuals fulfilling the eligibility criteria were referred to the base hospital in Kathmandu for a detailed clinical examination. The diagnosis of glaucoma was based upon criteria described by the International Society for Geographic and Epidemiological Ophthalmology (ISGEO). Results: Complete data was available on 3991 subjects (response rate 83.15 %). The mean IOP was 13.3 mm Hg (97.5 th and 99.5 th percentiles, 18 and 20 mm Hg, respectively) and mean VCDR 0.26 (97.5 th and 99.5 th percentiles, 0.6 and 0.8 mm Hg, respectively). Seventy-five subjects had glaucoma, an age-sex-standardized prevalence of 1.80 (95 % confidence interval (CI), 1.68 -1.92). The age-and sex-standardized prevalence of POAG was 1.24 % (CI, 1.14 -1.34), PACG 0.39 % (CI, 0.34 -0.45) and secondary glaucoma 0.15 % (CI, 0.07-0.36). The prevalence of glaucoma increased with increase in age and there was no significant difference in gender. Nine eyes were blind and two subjects bilaterally blind from glaucoma. Conclusion: The overall prevalence of glaucoma was 1.9 %. POAG was the most common form of glaucoma. Visual morbidity from PACG, however, was higher. A large majority of the subjects with POAG had not been previously diagnosed and had intraocular pressure within the normal range.

Glaucoma in Community: An Opportunistic Screening in Cataract Screening Programs

“…In this study, we found the majority of pa ents having POAG which is similar to other studies conducted in Nepal and [8][9][10][11][12][13] other south Asian countries. The study by Dr. Sah R. P. et al was a community based cross sec onal study done in 1600 10 pa ents above 40 years in Sunsari district of Nepal .…”

“…In Bhaktapur study conducted by Suman S Thapa et al reported POAG (1.245 %) being the highest among types of glaucoma which is similar to ours 12 having 1.78% However we didn't find any cases of PACG in our study. In another study by Suman S Thapa et al showed that approximately 2 to 4% of pa ents 50 years or older were 13 newly diagnosed with P0AG . Early detec on and treatment is necessary for reduc on of blindness due to glaucoma.…”

Referral parameters for diagnosis of glaucoma in general eye clinic at Tilganga Institute of Ophthalmology

“…In this study we found that there was an increase in the prevalence of glaucoma with the increasing age.The mean age at which glaucoma was diagnosed was 55.29 years. The results of our study are comparable to the results of Bhaktapur glaucoma study (Thapa SS et al 2013).…”

“…In this study the mean vertical cup disc ratio in the glaucoma diagnosis group was 0.69 compared to 0.56 which is similar to the results of Bhaktapur glaucoma study which states that the VCDR above 0.6 should be looked into with suspicion (Thapa SS et al 2013).…”

“…A provisional diagnosis was made on the basis of information available by the initial assessment in the department of glaucoma taking reference from Bhaktapur glaucoma study (Thapa SS et al, 2013) 1. Open angle glaucoma: Presence of open anterior chamber angles IOP > 21 mmHg with characteristic optic disc and/or visual fi eld changes, participants were diagnosed to have primary open angle glaucoma, if one or both eyes met any of the criteria mentioned below a) VCDR of 0.7 or greater or asymmetry between two eyes of 0.2 or more, and a visual fi eld defect consistent with glaucoma.…”