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Primary angle closure glaucoma: a developing world perspective.

Ravi Thomas1, G Chandra Sekhar, Rajul Parikh

  • 1L.V. Prasad Eye Institute, Banjara Marg, Banjara Hills, Hyderabad, Andhra Pradesh, India. ravithomas@lvpei.org

Clinical & Experimental Ophthalmology
|June 2, 2007
PubMed
Summary
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Primary angle closure glaucoma (PACG) significantly impacts developing nations. Early detection and treatment of primary angle closure suspects (PACS) and primary angle closure (PAC) are crucial for preventing vision loss.

Area of Science:

  • Ophthalmology
  • Public Health
  • Glaucoma Research

Background:

  • Primary angle closure glaucoma (PACG) disproportionately affects populations in developing countries.
  • A high percentage (over 80%) of individuals with glaucoma in developing nations remain undiagnosed.
  • PACG leads to more severe visual impairment compared to primary open-angle glaucoma.

Purpose of the Study:

  • To assess the public health burden of primary angle closure suspects (PACS) and primary angle closure (PAC) in developing countries.
  • To determine cost-effective strategies for PACG detection and management.
  • To extrapolate clinical trial data for individual patient care and population impact.

Main Methods:

  • Utilized Number Needed to Treat (NNT) to evaluate individual patient care efficacy.

Related Experiment Videos

  • Employed Population Attributable Risk percentage (PAR%) for population-level impact assessment.
  • Analyzed data to determine the progression rates from PACS to PAC and from PAC to PACG.

    • Main Results:

    • Treating PACS has an NNT of 6 over 5 years to prevent progression to PAC.
    • Treating PAC has an NNT of 5 over 5 years to prevent progression to PACG.
    • Effective PAR% for PACS is 56.4%, and for PAC is 65%, indicating significant health burdens.

    Conclusions:

    • Both PACS and PAC represent substantial health burdens in developing countries.
    • Population-based screening for PACG is likely unfeasible due to the lack of effective screening tests and high opportunity costs.
    • Developing cost-effective, targeted strategies for managing PACS and PAC is imperative.