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Changing views on open-angle glaucoma: definitions and prevalences--The Rotterdam Study
R C Wolfs1, P H Borger, R S Ramrattan
1Departments of Epidemiology and Biostatistics and. Ophthalmology, Erasmus University Rotterdam, The Netherlands.
Investigative Ophthalmology & Visual Science
|September 28, 2000
Summary
This study established diagnostic criteria for open-angle glaucoma (OAG) and found its prevalence in white adults over 55 was 0.8%. The findings highlight the importance of standardized criteria for accurate OAG diagnosis and prevalence estimation.
Area of Science:
- Ophthalmology
- Epidemiology
- Public Health
Background:
- Open-angle glaucoma (OAG) diagnosis relies on varying criteria, impacting prevalence estimates.
- Establishing standardized diagnostic criteria is crucial for epidemiological studies and clinical practice.
Purpose of the Study:
- To develop quantitative diagnostic criteria for OAG.
- To propose an epidemiologic definition for OAG.
- To determine the prevalence of OAG in a general white population aged 55 and older.
Main Methods:
- Utilized data from 6756 participants (aged 55+) in the population-based Rotterdam Study.
- Employed ophthalmoscopy, Imagenet, and Goldmann perimetry for masked assessment of optic disc parameters (e.g., vertical cup-to-disc ratio) and visual field defects.
- Applied established and novel criteria for OAG diagnosis to assess prevalence variations.
Main Results:
- The 97.5th percentile for vertical cup-to-disc ratio was 0.7.
- Prevalence of definite OAG in independently living subjects was 0.8% (95% CI 0.6, 1.0), with higher prevalence in men.
- Different diagnostic criteria yielded OAG prevalence figures ranging from 0.1% to 1.2%.
Conclusions:
- The study proposes a definition for definite OAG based on glaucomatous optic neuropathy and visual field loss, using population-specific percentiles.
- A significant variability in prevalence (factor of 12) was observed when applying different diagnostic criteria.
- Standardized criteria are essential for consistent OAG diagnosis and prevalence reporting in epidemiological research.