Trends in Childhood Glaucoma Prevalence and Incidence in South Korea, 2002–2019: A Nationwide Population-Based Study

Abstract

Précis: This nationwide analysis identified the prevalence and incidence of childhood glaucoma for an 18-year period. The prevalence and incidence of primary congenital glaucoma showed increasing trends. Juvenile open-angle glaucoma, meanwhile, showed a decreasing tendency. Purpose: We aimed to determine the trends in the prevalence and incidence of childhood glaucoma in the entire population of South Korea. Patients and Methods: A nationwide retrospective cohort study was performed with an age- and sex-specific population of South Korea. The Korean National Health Insurance Service (KNHIS) claims database for 2002 to 2019 was accessed to identify cases of ophthalmologist-confirmed primary childhood glaucoma (i.e., primary congenital glaucoma [PCG] and juvenile open-angle glaucoma [JOAG]). Incidence for PCG was estimated for a same-birth-year population, while that for JOAG was estimated using age- and sex-specific population figures. To verify the glaucoma cases, we also analyzed the diagnostic codes as well as any information on medication prescriptions and/or ocular-surgery history. Results: During the 18-year observational period, totals of 505 and 7538 patients were diagnosed as PCG and JOAG, respectively. The mean prevalences of PCG and JOAG were 3.96±0.72 and 14.17±5.18, respectively. The prevalence of PCG showed an overall increasing trend during the study period, but the pattern was not significant (β=0.049, P=0.143); that of JOAG, meanwhile, showed a significant decreasing tendency (β=-0.713, P=0.001). PCG prevalence showed no difference between urban and rural areas, but JOAG showed a higher prevalence in rural areas (P<0.001). As for mean incidence, the rates for PCG and JOAG were 1.54±0.49 and 5.02±1.95 (per 100,000 person-years), respectively, and were higher in males (P<0.001 and P=0.013). Conclusion: This study identified childhood glaucoma prevalence and incidence in a general population of East Asian ethnicity. This data could help to promote better understanding of the typical epidemiological features and clinical courses of childhood glaucoma patients.