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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
High burden of blindness at initial hospitalisation with primary angle-closure glaucoma in a national multicentre
Kun Xiong1, Huiyan Mao1, Jinyuan Chen2
1National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Insights
Over 40% of primary angle-closure glaucoma patients in China experience blindness upon hospitalisation. Older age, higher intraocular pressure, rural residence, and lower-level hospitals increase blindness risk.
Area of Science:
- Ophthalmology
- Public Health
- Glaucoma Research
Background:
- Primary angle-closure glaucoma (PACG) is a significant cause of vision loss globally.
- Understanding the prevalence and risk factors for blindness in PACG is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of blindness at initial hospitalisation for PACG in China.
- To identify risk factors associated with blindness in PACG patients.
Main Methods:
- A multistage stratified sampling method was employed across 26 hospitals in China.
- Data were collected from 3957 PACG patients between January 2011 and December 2020.
- Logistic regression models identified risk factors for either-eye and bilateral blindness.
Main Results:
- 42.7% of PACG patients experienced blindness in at least one eye, and 5.33% had bilateral blindness.
- Risk factors for blindness included older age (60+ years), higher intraocular pressure (IOP), rural residence, and presentation at city-level hospitals.
- Similar risk factors were identified for bilateral blindness.
Conclusions:
- A substantial proportion of PACG patients in China present with blindness.
- Interventions should prioritize improving diagnostic and treatment services in rural, city-level facilities.
- Focusing on older patients with elevated IOP is essential for reducing the burden of PACG-related blindness.
Objective:
To determine the prevalence and risk factors for blindness at initial hospitalisation with primary angle-closure glaucoma (PACG) and proposed glaucoma surgery in China.
Methods:
A multistage stratified sampling method was used to select patients with PACG (1 January 2011 to 31 December 2020) presenting for initial hospitalisation from hospitals of various levels (n=26): 2 nationally leading ophthalmic hospitals, 12 university-affiliated and provincial people's hospitals and 12 city-level hospitals. Blindness is defined according to WHO standards, with visual acuity <3/60 defined as blindness. We used separate logistic regression models to identify the risk factors for blindness in at least one eye and bilateral blindness.
Results:
Among the 3957 patients with PACG included in this study, 42.7% (n=1691) and 5.33% (n=211) had either-eye and bilateral blindness, respectively. In multivariable logistic models, participants with 60-69 years (ORs=1.28, 95% CI 1.06 to 1.55), 70-79 years (OR=2.27, 95% CI 1.85 to 2.78) and >80 years (OR=4.21, 95% CI 3.09 to 5.73) had a higher risk of either-eye blindness compared with those aged 50-59, higher intraocular pressure (IOP; OR=1.06 per mm Hg, 95% CI 1.05 to 1.07), residence in rural areas (OR=1.45, 95% CI 1.24 to 1.70) and presentation to city-level hospitals (vs higher-level facilities, OR=1.53, 95% CI 1.18 to 2.00) increased risk. Similar results were obtained for bilateral blindness.
Conclusions:
In China, two out of every five PACG patients presenting for initial hospitalisation experienced blindness in at least one eye. Efforts to reduce this burden should focus on improving diagnostic and treatment services at city-level facilities in rural settings while focusing on older patients presenting with higher IOP.
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