Risk of glaucoma in ocular hypertension with and without pseudoexfoliation
Received 7 April 2004; accepted 14 September 2004.
Purpose
To compare glaucoma conversion rates in patients with ocular hypertension (OH) with and without pseudoexfoliation.
Design
Cohort study, based on 32 918 screening participants.
Participants and controls
Ninety-eight patients with OH and pseudoexfoliation and 98 matched controls.
Main outcome measure
Perimetric glaucoma conversion.
Methods
A population-based glaucoma screening of elderly citizens of Malmö, Sweden, was conducted between 1992 and 1997 to recruit participants for the Early Manifest Glaucoma Trial. Screening participants with intraocular pressure (IOP) between 24 and 32 mmHg and pseudoexfoliation were compared to controls among other screening participants without pseudoexfoliation but matched for baseline IOP, age, and gender, and the 2 groups were invited to a reexamination. Computerized visual field tests were performed to identify persons with manifest glaucoma. Visual acuity, refraction, IOP, and central corneal thickness were also measured.
Results
After a mean of 8.7 years (range: 6.3–11.4), 54 of 98 patients (55.1%) with pseudoexfoliation at the baseline examination and 27 of 98 patients (27.6%) without pseudoexfoliation had developed glaucoma. The risk ratio was 2.0 (P<0.0001).
Conclusion
The glaucoma conversion rate was twice as high in patients with OH and pseudoexfoliation as in control patients matched for IOP, age, and gender. Thus, pseudoexfoliation was a strong independent risk factor for glaucoma in patients with OH.
Department of Ophthalmology, Malmö University Hospital, University of Lund, Malmö, Sweden
Correspondence and reprint requests to Kirsti Grødum, MD, PhD, Department of Ophthalmology, Malmö University Hospital, S-20502 Malmö, Sweden
Manuscript no. 240265.
This study was supported by the Swedish Research Council (grant no.: K2002-74X-10426-10A), Malmö University Hospital, and the Järnhardt Foundation.
The authors have no proprietary or financial interest in any of the material in this article.
ABSTRACT