Prevalence and Severity of Undetected Open-Angle Glaucoma in Persons 77 to 89 Years Old

To determine the prevalence and severity of previously undetected open-angle glaucoma (OAG) in individuals aged 77 to 89 years in Malmö, Sweden.

Cross-sectional study.

All residents of Malmö, Sweden, aged 77 to 89 years were eligible for participation, except individuals with a prior glaucoma diagnosis at Skåne University Hospital. A total of 1957 individuals were invited, of whom 602 (30.8%) attended the screening.

The screening procedure included intraocular pressure measurement using an iCare tonometer, visual field screening using the Frequency Doubling Technology perimeter, and fundus photography. Subjects with positive screening results were offered a postscreening visit with a full ophthalmological examination, including threshold perimetry using the Swedish Interactive Threshold Algorithm Standard 24-2 program of the Humphrey Field Analyzer. The severity of disease was evaluated based on the perimetric mean deviation index.

Prevalence of previously undetected OAG in individuals aged 77 to 89 years (%) and the magnitude of visual field defects expressed as proportions (%) of patients in 5 different disease severity stages.

The prevalence of previously undetected OAG was 5.98% (95% confidence interval: 4.2%-8.2%), n = 35 patients. The condition was unilateral in 74% of patients. The severity of disease was early in 66% and moderate in 20%, while 14% of patients had advanced or severe disease. No patient had developed end-stage disease. The median intraocular pressure in glaucoma patients was 16 mmHg (interquartile range: 14-19 mmHg).

The prevalence of previously undetected OAG was high in this age category, 5.98%, but most patients had early or moderate disease, and no patient had end-stage disease.

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