Incidencia a quince años de glaucoma de ángulo abierto: el estudio de los ojos de las Montañas Azules

To assess the 15-year cumulative incidence of open-angle glaucoma (OAG) in an older Australian population.

Population-based cohort study.

3654 Blue Mountains Eye Study participants from Australia, aged 49-97 years were examined during 1992-1994. Of these, 2335 (75.8% of survivors) were re-examined after 5 years (1997-1999), 1952 (76.7% of survivors) after 10 years (2002-2004), and 1149 (56.1% of survivors) after 15 years (2007-2010).

Goldmann applanation tonometry, stereoscopic optic disc photography and automated perimetry were performed at baseline and follow-up studies. Glaucoma suspects returned for perimetry, gonioscopy and repeat perimetry and tonometry. After excluding persons with OAG at baseline, incident definite OAG was diagnosed when glaucomatous optic disc changes were congruous with visual field defects at any follow-up study. Incident probable OAG included participants with structural glaucomatous optic disc changes with inconsistent visual field loss. Cumulative and age-standardised incidence rates were estimated using Kaplan-Meier estimates.

Cumulative and age-standardised 15-year incidence of definite and probable OAG, and associated risk factors.

Incident definite OAG developed in 116 subjects and probable OAG in 24 subjects, a total of 140 cases. The age-standardised 15-year incidence was 5.67% (95% confidence interval (CI): 4.65-6.68) for definite and probable OAG, and 4.72% (95% CI: 3.79-5.64) for definite OAG. After adjusting for competing risks, incidence of definite and probable OAG was 5.57% (95% CI: 4.66-6.47) and definite OAG was 4.81% (95% CI: 3.96-5.66). Age, pseudoexfoliation, myopia (≥3D) and IOP were strong risk factors for 15-year incidence of OAG.

This study documented the 15-year incidence of OAG and associated risk factors in an older Australian population. These data are useful for long term planning of glaucoma-related health services delivery.