Risk factors for late presentation of chronic glaucoma in an Iranian population

To identify risk factors for late presentation in chronic glaucoma.

In a hospital-based case-control study, 312 newly diagnosed consecutive patients with chronic glaucoma were recruited to study in Nikookari Hospital in Tabriz - Iran. Cases were defined as patients presenting with absolute field loss within 5° of fixation or a cup to disc ratio >0.8 in one or both eyes (188 patients). Controls were patients with no absolute field loss within 20° in either eye but otherwise glaucomatous field loss and a cup to disc ratio >0.5 or a difference of 0.2 or greater between the discs (124 patents).

In logistic regression model, there was a significant association between late presentation and male gender, lower education status, pseudoexfoliative glaucoma, high intraocular pressure (IOP) in the first presentation and no eye exam in last 2 years. Patients with pseudoexfoliative glaucoma had 1.5 times more odd for late presentation (1.52 confidence interval [CI]: 1.14-2.24 P = 0.004). Patients that visited by an ophthalmologist in the last 2 years had 0.5 less likely to present with advanced glaucoma (0.54 CI: 0.32-0.92 P = 0.025). Higher IOP in initial examination was associated with advanced glaucoma. We estimated 1.08 increase in odd (CI: 1.03-1.04 P = 0.001) per increase in 1 mmHg in IOPs above 25 mmHg.

Our study shows that several risk factors present for late presentation in chronic glaucoma. Our results suggest planning screening programs in high-risk individuals for early detection of glaucoma and prevention of blindness.