Distribution of glaucomas by type, stage of development and therapy

To establish the distribution of glaucomas by type and stage of development and analyze their treatment on the basis of free examinations of glaucoma patients.

Three hundred and two consecutive glaucoma patients (91 males and 211 females, mean age 66.5+/-11.6 years, mean duration of disease 4.4 years) were investigated. Each patient underwent examination of the intraocular pressure (IOP), anterior eye segment, fundus oculi, and recommendations about further treatment were given.

Females were 70% of the investigated subjects (the ratio of men to women was 1:2.3). Sixty-seven patients (22%) had a family history of glaucoma. Fifty-one (17%) of the glaucoma patients had diabetes mellitus, and 174 (58%)--arterial hypertension. Pseudoexfoliations on the pupillary margin and on anterior lens capsule were observed in 51 patients (17%). The distribution of glaucomas by type was as follows: primary open-angle glaucoma (POAG)--209 patients, pseudoexfoliation glaucoma (PEG)--50 patients, normal-tension glaucoma (NTG)--15 patients, closed-angle glaucoma (CAG)--9 patients, pigmentary glaucoma--6 patients, juvenile glaucoma--1 patient, congenital glaucoma--1 patient, secondary glaucoma--11 patients. According to the stage of the disease the investigated eyes were distributed as follows: early stage of glaucoma--41%, evolution stage--20%, progressive stage--19%, terminal stage--8%. Ten percent of the eyes presented with ocular hypertension and were suspect for glaucoma, while 2% were without glaucoma. Prostaglandin analogues were the most frequently used antiglaucoma topical drugs (45%), followed by beta-blockers (35%). The therapeutic approach was changed for 104 glaucoma patients (34%).

The primary open-angle glaucoma has the highest frequency in our sample approximately 70% of the cases of glaucomas; pseudoexfoliation glaucoma has a relatively low frequency--17% and the low pressure glaucoma has a surprisingly low relative percentage in the sample. Therapy was changed in more than a third of the examined glaucoma patients--change in the drug therapy or referring patients for antiglaucoma surgery.