Nine-Year Incidence of Open-Angle Glaucoma in the Barbados Eye Studies

Leske, M. Cristina; Wu, S.Y.; Honkanen, R.; Nemesure, B.; Schachat, A.; Hyman, L.; Hennis, A.; Barbados Eye Studies Group,

doi:10.1016/j.ophtha.2006.08.051

« Previous Next »Ophthalmology
Volume 114, Issue 6 , Pages 1058-1064, June 2007

Nine-Year Incidence of Open-Angle Glaucoma in the Barbados Eye Studies

M. Cristina Leske, MD, MPH
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York.
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York.
- Correspondence to M. Cristina Leske, Department of Preventive Medicine, Stony Brook University, L3 HSC Room 086, Stony Brook, NY 11794-8036.
S.Y. Wu, MA
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York.
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York.
R. Honkanen, MD
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York.
B. Nemesure, PhD
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York.
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York.
A. Schachat, MD
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
L. Hyman, PhD
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York.
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York.
A. Hennis, FRCP(UK), PhD
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York.
- Ministry of Health, Bridgetown, Barbados.
- Chronic Disease Research Centre, Tropical Medicine Research Institute, University of the West Indies, Bridgetown, Barbados.
Barbados Eye Studies Group
- For Group membership, see Leske MC, Wu SY, Hennis A, et al. Nine-year incidence of age-related macular degeneration in the Barbados Eye Studies. Ophthalmology 2006;113:29–35.

Received 6 July 2006; accepted 29 August 2006. published online 31 March 2007.

Purpose

To determine the 9-year incidence of open-angle glaucoma (OAG) in African-descent participants of the Barbados Eye Studies.

Design

Nine-year cohort study with 81% to 85% participation.

Participants

Three thousand two hundred twenty-two persons without definite OAG at baseline, at risk of developing OAG at follow-up.

Methods

The standardized protocol included automated perimetry and various ophthalmic measurements, with a comprehensive ophthalmologic examination for those referred. Fundus photographs were evaluated independently by masked graders. Incidence was estimated by the product-limit approach. Relative risk (RR) ratios with 95% confidence intervals (CIs) were based on Cox regression models with discrete time.

Main Outcome Measure

Nine-year incidence of definite OAG, based on the development of visual field defects and glaucomatous optic neuropathy, with ophthalmologic confirmation.

Results

The 9-year incidence of definite OAG was 4.4% (95% CI, 3.7%–5.2%), or an average of 0.5%/year, based on 125 new cases. Incidence increased greatly with age, from 2.2% at ages 40 to 49 years to 7.9% at ages 70 years or older, and tended to be higher in men than women (4.9% vs. 4.1%; RR, 1.3; 95% CI, 0.9–1.8). More than half (53%) of new cases were undetected, and of these, one third had intraocular pressure of 21 mmHg or less. When 141 persons developing suspected/probable OAG were considered, the total incidence was 9.4% (8.4%–10.6%), averaging approximately 1%/year, also increasing with age, and significantly higher in men than women (10.7% vs. 8.6%; RR, 1.31; 95% CI, 1.02–1.67).

Conclusions

These new data provide a measure of the long-term risk of OAG in an African-descent population, which is markedly higher than in persons of European ancestry. Results confirm the increased risk with age and in men. The incidence data fill a gap in our understanding of OAG risk and have implications for public health policy and planning; they also will allow the study of factors related to the risk of OAG development.