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Glaucoma and intraocular pressure in EPIC-Norfolk Eye Study: cross sectional study
Michelle P Y Chan1, David C Broadway2, Anthony P Khawaja3
1Division of Genetics and Epidemiology, UCL Institute of Ophthalmology, London EC1V 9EL, UK.
BMJ (Clinical Research Ed.)
|September 15, 2017
Summary
Intraocular pressure (IOP) measurement is an inaccurate method for detecting glaucoma, with many newly diagnosed cases having IOP below the typical threshold. This highlights the need for improved diagnostic strategies for this common eye condition.
Area of Science:
- Ophthalmology
- Public Health
- Epidemiology
Background:
- Glaucoma is a leading cause of irreversible blindness worldwide.
- Early detection and management are crucial to prevent vision loss.
- Intraocular pressure (IOP) is a primary risk factor and diagnostic indicator for glaucoma.
Purpose of the Study:
- To determine the distribution of intraocular pressure (IOP) by age and sex.
- To estimate the prevalence of glaucoma within a community cohort.
- To evaluate the accuracy of IOP measurements for diagnosing glaucoma.
Main Methods:
- A community-based, cross-sectional observational study was conducted.
- 8,623 participants aged 48-92 from the EPIC-Norfolk cohort underwent ocular examinations.
- Data on glaucoma prevalence, IOP distribution, and diagnostic test performance were collected.
Main Results:
- The mean IOP was 16.3 mm Hg.
- Glaucoma was present in 4% of participants, with primary open-angle glaucoma being most common.
- A significant proportion of newly diagnosed primary open-angle glaucoma cases (76%) had IOP below 21 mm Hg.
Conclusions:
- Glaucoma, suspected glaucoma, and ocular hypertension represent a substantial burden requiring hospital eye services.
- Relying solely on IOP thresholds for glaucoma detection is inaccurate and likely not a viable strategy.
- Improved diagnostic methods are needed for effective glaucoma case finding.
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