Differentiating Diagnosed and Undiagnosed Primary Angle-Closure Glaucoma and Open-Angle Glaucoma: A Population-Based...

Area of Science:

• Ophthalmology
• Epidemiology
• Public Health

Background:

• Glaucoma, a leading cause of irreversible blindness, exists in primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) subtypes.
• Understanding factors differentiating diagnosed from undiagnosed cases is crucial for early detection and intervention strategies.

Purpose of the Study:

• To compare factors distinguishing diagnosed from undiagnosed cases of PACG and POAG within a defined population.
• To identify specific clinical parameters associated with prior diagnosis in each glaucoma type.

Main Methods:

• A population-based survey was conducted on residents aged 40 and older in Kumejima, Japan.
• Multivariate logistic regression analysis was employed to identify significant differentiating factors from systemic, ocular, visual function, and fundus parameters.

Main Results:

• The prevalence of PACG was 2.2% and POAG was 4.0%.
• A significantly higher proportion of PACG cases (34.1%) had a prior diagnosis compared to POAG cases (17.2%).
• Worse visual field mean deviation and signs of previous acute angle closure were associated with diagnosed PACG, while a larger vertical cup-to-disc ratio was marginally associated with diagnosed POAG.

Conclusions:

• PACG was more likely to be previously diagnosed than POAG during screening.
• Anterior segment examination and visual field testing may be more beneficial for detecting PACG.
• Optic disc examination may be more valuable for detecting POAG.