A comparative study of anterior segment variables between glaucomatous and non-glaucomatous Ghanaians

Primary open-angle glaucoma is a major public health concern, particularly in Africa. Identifying population-specific risk factors for the disease will enable eye health clinicians to more precisely identify persons at risk for the disease.

Ghana has a high prevalence of primary open-angle glaucoma. This study compared anterior segment ocular variables associated with primary open-angle glaucoma between a glaucomatous and non-glaucomatous Ghanaian population which may provide more insight into the aetiology of the disease.

Central corneal thickness, corneal diameter, corneal volume, anterior chamber angle, anterior chamber depth, and anterior chamber volume measurements were extracted from Pentacam results of 356 persons with primary open-angle glaucoma (mean age: 62.84 ± 14.59) and 311 controls (mean age: 60.80 ± 9.09). Intraocular pressure was measured using Goldmann applanation tonometry. Analysis of variance was used to compare means the measured ocular variables among the primary open-angle glaucoma and control groups. Cohen's d effect sizes and multivariate logistic regression were used to determine the primary open-angle glaucoma effect sizes and associations between primary open-angle glaucoma and the measured variables.

Thinner central corneal measurements were moderately associated with severe primary open-angle glaucoma (aOR = 0.59; 95% CI: 0.40-0.87). Lower corneal volume measurements were associated with moderate primary open-angle glaucoma (aOR = 0.63; 95% CI: 0.40-0.99) and highly associated with severe primary open-angle glaucoma (aOR = 0.47; 95% CI: 0.32-0.70). Elevated intraocular pressure was highly associated with all stages of primary open-angle glaucoma (aOR > 4.02), with the strength of this association increasing with severity of primary open-angle glaucoma.

Risk factors for different stages of severity of primary open-angle glaucoma are revealed. Thinner central corneas, lower corneal volumes, and elevated intraocular pressure measurements are risk factors for primary open-angle glaucoma in Ghanaians.