Clinico-demographic Profile of Patients with Early Primary Open Angle Glaucoma at a Tertiary Private Eye Hospital in Lagos, Nigeria
Main Article Content
Keywords
Early Glaucoma, Primary Open Angle Glaucoma, Clinico-Demographic Profile, Vessel Density.
Abstract
Background: This study aimed to characterize the clinical and sociodemographic profiles of Nigerian patients with early-stage primary open-angle glaucoma (POAG), with the goal of highlighting the significance of timely diagnosis in enhancing glaucoma treatment outcomes.
Methodology: This cross-sectional study involved participants aged ≥ 40 years with early POAG. The participants underwent a slit-lamp examination of the anterior and posterior segments. The examination included gonioscopy, after which only eyes with open angles were selected. A central visual field test was conducted, and one eye of each participant who met the criteria for early POAG was selected for optical coherence tomography/angiography test (OCT/A). The relevant data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26, with statistical significance set at p<0.05, with a 95% confidence interval.
Results: There were 90 participants with a mean age of 54.5 ± 10.1 years, comprising 54 males (60%). All participants had a best-corrected visual acuity (BCVA) of at least LogMAR 0.48, and the mean central visual field (CVF) MD was -3.50 ± 1.0 dB. The mean retinal nerve fiber layer (RNFL) thickness was 97.79 ± 17.33. The mean peripapillary vessel density (VD) was 50.21 ± 4.54%. Nearly half (47.8%) of the participants had other systemic medical conditions, primarily hypertension or hyperlipidemia.
Conclusion: Patients with early POAG were asymptomatic and had good visual acuity and minimal RNFL thickness reduction. This highlights the importance of routine hospital screening of people 40 years and older to aid early diagnosis of POAG.
References
2. Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet 2004; 363(9422): 1711-1720.
3. Quigley H, Broman A. The number of people with glaucoma worldwide. Br J Ophthalmol 1996; 80: 389-93.
4. Lewallen S, Courtright P. Blindness in Africa: Present situation and future needs. Br J Ophthalmol 2001; 85: 879-903.
5. Abdull M, Sivasubramaniam S, Murthy G, Gilbert C. Causes of blindness and visual impairment in Nigeria: The Nigeria national blindness and visual impairment survey. Invest Ophthalmol Vis Sci 2009; 50: 4114-20.
6. Bourne R, Steinmetz JD, Flaxman S, Briant PS, Taylor HR, Resnikoff S, et al. Trends in prevalence of blindness and distance and near vision impairment over 30 years: An analysis for the global burden of disease study. Lancet Glob Health. 2021; 9(2):e144–e160. pmid:33275949; PMCID: PMC7820390.
7. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014; 121: 2081–90.
8. Kyari F, Entekume G, Rabiu M et al. A population-based survey of the prevalence and types of glaucoma in Nigeria. BMC Ophthalmol. 2015; 15: 176.
9. Olawoye O, Tarella S. Spectrum of glaucoma presentation in a Nigerian tertiary hospital. Niger J Ophthalmol 2014: 22: 11-5.
10. Adekoya, B.J., Shah, S.P., Onakoya, A.O. et al. Glaucoma in southwest Nigeria: clinical presentation, family history and perceptions. Int Ophthalmol 34, 1027-1036 (2014). https://doi.org/10.1007/s10792-014-9903-2.
11. Abdull, M.M., Gilbert, C.C. & Evans, J. Primary open angle glaucoma in northern Nigeria: stage at presentation and acceptance of treatment. BMC Ophthalmol 15, 111 (2015). https://doi.org/10.1186/s12886-015-0097-9.
12. Hodapp E, Parrish RK 2nd, Anderson DR. Clinical decisions in glaucoma. St. Louis: CV Mosby; 1993. pp. 52–61.
13. Yarmohammadi A, Zangwill LM, Diniz-Filho A, Suh MH, Yousefi S, Saunders LJ, Belghith A, Manalastas PI, Medeiros FA, Weinreb RN. Relationship between optical coherence tomography angiography vessel density and severity of visual field loss in glaucoma. Ophthalmology. 2016 Dec 1;123(12):2498-2508.
14. American Academy of Ophthalmology. Basic and Clinical Sciences Course 2019/2020, Section 10; 36-81.
15. Kizor-Akaraiwe NN. Glaucoma in self-reported relatives and non-relatives of Igbo glaucoma patients in Enugu, Nigeria. World Journal of Advanced Research and Reviews. 2021;9(3):218-25.
16. Alpha Madu, Omumuawuike Ebi, Emmanuel Ihekweazu, Valerie Chizelum Okosi. Prevalence of Hypertension in Glaucoma Patients Attending Eye Clinics in Two Teaching Hospitals in Enugu State Nigeria: A Descriptive Cross-Sectional Study. American Journal of Medicine Studies. Vol. 8, No. 1, 2020, pp 1-5. http://pubs.sciepub.com/ajms/8/1/1.
17. Zhou M, Wang W, Huang W, Zhang X. Diabetes mellitus as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. PLoS One. 2014 Aug 19; 9 (8): e102972. doi: 10.1371/journal.pone.0102972. PMID: 25137059; PMCID: PMC4138056.
18. Shiming Wang, Xianyi Bao; Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis. Invest. Ophthalmol. Vis. Sci. 2019;60(4):1028-1043.
19. Abikoye TM, Oluleye TS, Aribaba OT, et al. Is primary open-angle glaucoma a risk factor for diabetic retinopathy? International Ophthalmology. 2020 Dec;40(12):3233-3240. DOI: 10.1007/s10792-020-01507-0.
20. Song BJ, Aiello LP, Pasquale LR. Presence and Risk Factors for Glaucoma in Patients with Diabetes. Curr Diab Rep. 2016 Dec;16(12):124. doi: 10.1007/s11892-016-0815-6. PMID: 27766584; PMCID: PMC5310929.
21. Nathaniel G I, Ogunro A, Awoyesuku E A. The correlation between frequency doubling technology matrix mean deviation and peripapillary retinal nerve fiber thickness of newly diagnosed glaucoma patients. Int J Med Ophthalmol 2020; 2 (1): 32-36.
22. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M; Early Manifest Glaucoma Trial Group. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002 Oct;120(10):1268-79. doi: 10.1001/archopht.120.10.1268. PMID: 12365904.
23. K. P. Mashige and O. A. Oduntan. Retinal nerve fibre layer thickness values and their associations with ocular and systemic parameters in Black South Africans. African Health Sciences, vol. 16, no. 4, p. 1188, 2017.
24. Ocansey S, Kwasi Abu E, Owusu-Ansah A etal. Normative values of Retinal Nerve Fibre Layer Thickness and Optic Nerve Head Parameters and Their Association with Visual Function in an African Population. Journal of Ophthalmology, vol. 202, article ID 7150673, 14 pages, 2020.
25. Köse HC, Tekeli O. Optical coherence tomography angiography of the peripapillary region and macula in normal, primary open angle glaucoma, pseudoexfoliation glaucoma and ocular hypertension eyes. Int J Ophthalmol 2020;13(5):744-754.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.