Epidemiology of Optic Atrophy among the Patients Attending a Tertiary Care Hospital, Ongole, Prakasham District, AP (original) (raw)
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IOSR Journals , 2019
Introduction: Visual impairment is a global public health problem and glaucoma is the leading cause of irreversible blindness worldwide.Primary angle-closure glaucoma (PACG) and primary angle closure (PAC) are more common in East Asian countries than in Western countries, and the former often results in bilateral blindness. in the Department of Ophthalmology. The study was a descriptive observational study. Written informed consent procedure was followed in all patients recruited into the study.The study group consisted of 950 patients aged 40 years and above, belonging to both sexes; these patients presented themselves for their geriatric ocular problems like Presbyopia, Refractive errors, Diminution of vision, Diabetes, Hypertension, Migraine, Cardiovascular disorders as referred from the department of Medicine for Ophthalmic evaluation. Results: Out of 950 patients screened, open angle glaucoma was noted in 50 cases. This shows the prevalence of open angle glaucoma as 5%. Out of which, 33 were diagnosed to have primary open angle glaucoma(POAG), 13 were normal tension glaucoma(NTG) and 4 had ocular hypertension. There was a steady increase in the number of cases of glaucoma as age advances in those who show an ocular tension of 21 mmHg and above. Average IOP for both sexes in 50 cases of open angle Glaucoma is 23.22 mmHg. Thirty-one patients with POAG and NTG had early field defects. 25 patients showed established field defects and 30 patients showed advanced field defects at least in one eye. Advanced field defects were seen with an increase in CDR of 0.7 and above in 30 patients. A positive family history of open angle glaucoma was elicited in 15 cases of POAG in the first-degree relatives. Conclusion: The prevalence of open angle glaucoma in this hospital-based study was 5%. Age, elevated intra-ocular tension, large cup/disc ratio, asymmetric cupping, myopia, disc haemorrhage, diabetes and positive family history are proven as risk factors in the current study. Elevated IOP is the most important risk factor for the development of glaucoma.
Clinical and epidemiological study in patients with primary open-angle glaucoma
Revista Brasileira de Oftalmologia, 2018
Objective: To evaluate the clinical and epidemiological profile of patients with primary open-angle glaucoma. Methods: This is a quantitative study with cross-sectional and analytical design, which sample consisted of 425 patients treated in an unit of Specialized Care in Ophthalmology, located in the northern state of Minas Gerais, from 2004 to 2015. We collected the data using formularies that addressed demographic and clinical aspects, risk factors and the presence of undercurrent diseases. We conducted an ophthalmological examination to evaluate anatomical and functional changes. We used statistical analysis, and the results are presented by mean, standard deviation and percentiles 25, 50 and 75. Results: Females predominate (56.8%), the age group of 60 years or older (44%) and mixed skin (81.7%). A minority of participants present risk factors such as high myopia (6.3%) and diabetes mellitus (17.9%). Regarding the clinical examination, there is a prevalence of increased optic nerve excavation (≥ 0.8) and low thickness of the corneas (≤ 535 microns). Conclusion: Most people develop advanced glaucoma, with increased optic nerve excavation and changed visual fields. Other common risk factors are: family history of glaucoma, decreased thickness of the cornea and hypertension. Early diagnosis and treatment can prevent vision loss. Primary care physicians should consider referring patients who have glaucoma risk factors, for an ophthalmologic examination.
A Study of profile of glaucoma in eastern UP
Indian Journal of Clinical and Experimental Ophthalmology, 2016
Objective: To study the profile of glaucoma patients in Eastern UP. Method: Prospective cross sectional study includes 193 cases of age group (more than 30 years). Both male and female were included. Results: The total number of 193 cases was studied. Out of these 106 (54.9%) were male and 87 (45.07%) were female with a male female ratio was 1.21. Primary glaucoma was more common than secondary glaucoma. Among primary glaucoma, primary narrow angle glaucoma (44.4%) was more common followed by primary open angle glaucoma (36.2%). Mean age of POAG patients was (54.2±7.2 years), PNAG was (60.1±11.1 years), NTG was of (64.6±11.8 years), ocular hypertension was of (55±7.2 years) and secondary glaucoma was of (53.2±11.2 years). PNAG was more common in females and rest of glaucoma was common in male. Glaucoma, Profile, Visual impairment, Eastern U.P. Conclusion: Glaucoma causes progressive atrophy of the optic disc resulting in typical defects in the visual field. It can lead to total loss of vision if left untreated. The diagnosis glaucoma has to be made only after comprehensive eye examination and not only on one parameter. Regular follow up is must to access progression which is essential for glaucoma. Glaucoma awareness has to be created among peoples, for them to get examined at early stage to rule out presence of glaucoma. If glaucoma is found, appropriate management is provided to prevent visual function impairment or loss.
Pattern of Glaucoma in Rural South India
Innovative Publication, 2017
Introduction: Primary Open Angle Glaucoma causes damage to the fibers of optic nerve which results in permanent visual loss. There may not be any symptoms; this is dangerous because patient may become blind silently. Glaucoma caused by angle closure mechanism causes symptoms and patient seeks medical attendance early. Aims and Objectives: To study clinical types and Factors associated with the Glaucoma patients. Methodology: This was cross-sectional study of the patients reporting to ophthalmology outpatient department or admitted in the ophthalmology wards having symptoms suggestive of Glaucoma, at tertiary health care center during the year 2016. The patients underwent detailed elucidation of history and examination. All essential investigations were undertaken. Attention was also paid to monitor treatment response and follow up. As per above criteria total 64 patients were included into the study. Result: Majority of the Glaucoma patients were from older age group. As age increases the problem of Glaucoma was more prevalent. It was more frequent in Males. More patients had Open angle Glaucoma than close angle or narrow angle. The most common associated factors with Glaucoma patients were Diabetes followed by Systemic Hypertension; Phacomorphic; post Iridocyclitis; Steroid induced Glaucoma; Traumatic Glaucoma. Conclusion: The problem of Glaucoma was more common in Older age and in males. The most common associated factors with Glaucoma patients were Diabetes followed by Systemic Hypertension; Phacomorphic; post Iridocyclitis; Steroid induced Glaucoma; Traumatic Glaucoma. So these factors should be considered during diagnosis and management of Glaucoma patients.
Association of risk factors with the severity of primary open angle glaucoma
IP innovative publication pvt ltd , 2020
Aim: To study the associations of risk factors with the severity of primary open angle glaucoma. Materials and Methods: A total of 98 patients were enrolled in the study as per the inclusion criteria. A complete ophthalmologic examination including a medical history review, best-corrected visual acuity, slit lamp examination and visual field assessment with Carl Zeiss Perimeter was done. Results: 98 patients were studied. The mean age of the patients was 60 10.3 years. There were 49% males and 51% females. Out of the participants, 22% had mild glaucoma, 37% had moderate glaucoma and 41% had severe glaucoma. Age was associated with 56% increase in likelihood of severe glaucoma per decade compared to mild disease. Myopia was seen in 60% of patients from the severe glaucoma group. Hypertension was seen in 49% of the participants. Diabetes was seen in 27%. Family history of 7% was noted. Hypothyroid was seen in 6% of the patients. Conclusion: In out study, we found that advancing age; myopia; hypertension and hypothyroid had a correlation with POAG. However, the association of diabetes with POAG did not have a reliable conclusion.
Prevalence of Open-Angle Glaucoma in a Rural South Indian Population
Investigative Ophthalmology & Visual Science, 2005
PURPOSE. To determine the prevalence of primary open-angle glaucoma (POAG) and the associated risk factors in a rural population in southern India. METHODS. Subjects aged 40 years or more (n ϭ 3934) underwent a complete ophthalmic examination. Glaucoma was diagnosed according to the International Society of Geographical and Epidemiologic Ophthalmology classification. RESULTS. Complete data were available for 3924 subjects (response rate, 81.75%). In eyes with normal suprathreshold visual fields, the mean intraocular pressure was 14.29 Ϯ 3.32 mm Hg (97.5th and 99.5th percentiles, 21 and 25 mm Hg, respectively). The mean vertical cup-to-disc ratio was 0.39 Ϯ 0.17 (97.5th and 99.5th percentiles, 0.7 and 0.8, respectively). Sixtyfour subjects had definite POAG (1.62%, 9.5% CI 1.42-1.82); 30 were men and 34 were women. Subjects with POAG (59.85 Ϯ 10.43 years) were older (P Ͻ 0.001) than the study population (53.78 Ϯ 10.71 years). In only one (1.5%) person was POAG diagnosed before the study. Two (3.12%) subjects were blind due to POAG; 21 (32.81%) subjects had a presenting IOP Ͼ21 mm Hg, and 43 (67.19%) had an IOP Ͻ21 mm Hg. The mean central corneal thickness in subjects with POAG (502.82 Ϯ 35.29 m) was not different from that of the normal study population (505.93 Ϯ 31.11 m). No association was found with diabetes mellitus, systemic hypertension, gender, and myopia. Increasing IOP (per mm Hg) was associated with the disease (OR 1.12; 95% CI, 1.08-1.16). The odds for POAG increased with advancing age after adjustment for gender. CONCLUSIONS. The prevalence of POAG in this population was 1.62%. The prevalence increased with age, and 98.5% were not aware of the disease.
Glaucoma in a rural population of southern India
Ophthalmology, 2003
To determine the prevalence of glaucoma and risk factors for primary open-angle glaucoma in a rural population of southern India. Design: A population-based cross-sectional study. Participants: A total of 5150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. Methods: All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of the minimum angle of resolution illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Main Outcome Measures: Definite primary open-angle glaucoma (POAG) was defined as angles open on gonioscopy and glaucomatous optic disc changes with matching visual field defects, whereas ocular hypertension was defined as intraocular pressure (IOP) greater than 21 mmHg without glaucomatous optic disc damage and visual field defects in the presence of an open angle. Manifest primary angle-closure glaucoma (PACG) was defined as glaucomatous optic disc damage or glaucomatous visual field defects with the anterior chamber angle partly or totally closed, appositional angle closure or synechiae in the angle, and absence of signs of secondary angle closure. Secondary glaucoma was defined as glaucomatous optic nerve damage and/or visual field abnormalities suggestive of glaucoma with ocular disorders that contribute to a secondary elevation in IOP. Results: The prevalence (95% confidence interval) of any glaucoma was 2.6% (2.2, 3.0), of POAG it was 1.7% (1.3, 2.1), and if PACG it was 0.5% (0.3, 0.7), and secondary glaucoma excluding pseudoexfoliation was 0.3% (0.2,0.5). On multivariate analysis, increasing age, male gender, myopia greater than 1 diopter, and pseudoexfoliation were significantly associated with POAG. After best correction, 18 persons (20.9%) with POAG were blind in either eye because of glaucoma, including 6 who were bilaterally blind and an additional 12 persons with unilateral blindness because of glaucomatous optic neuropathy in that eye. Of those identified with POAG, 93.0% had not been previously diagnosed with POAG. Conclusions: The prevalence of glaucoma in this population is not lower than that reported for white populations elsewhere. A large proportion of those with POAG had not been previously diagnosed. One fifth of those with POAG had blindness in one or both eyes from glaucoma. Early detection of glaucoma in this population will reduce the burden of blindness in India.
Purpose- To know the clinical profile and distribution of various subtypes of glaucoma in patients who presented to V.S.S Institute of Medical Sciences And Research. Methods- All the patients attending the Ophthalmology department, V.S.S. Institute of Medical Sciences and Research, Burla from November 2014 to November 2016 with a history and ocular examinations suggestive of glaucoma were included in the study. Results- A total of 280 cases were studied. Out of these males constituted 153 (54.64%) of total cases and the females were 127 (45.35%) of the study. Primary glaucoma was more common than secondary glaucoma. Among primary glaucoma, primary open angle glaucoma (38.92%) was more common than primary angle closure glaucoma (37.5%). Mean age of POAG patients was 58.22?8.95 years, mean age of PACG patients was 61.67?9.13 years and the mean age of NTG patients was 60.38?9.89 years. Hypertension (22.5%) and diabetes (12.1%) were found in large numbers compared to other systemic condition. Conclusion- The goal should be to atleast diagnose and manage the clear cut cases of glaucoma with established functional loss. This is possible only when we adopt comprehensive eye examinations such as IOP measurement, optic disc evaluation and gonioscopy as a routine.