Author(s): Leske MC, Wu SY, Honkanen R, Nemesure B, Schachat A,
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Abstract 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.
This article was published in Ophthalmology
and referenced in Journal of Clinical & Experimental Ophthalmology