Comparison of moderate and advanced glaucoma patients in Ghana

Abstract

Purpose

To compare moderate and advanced glaucoma patients in Ghana.

Methods

A retrospective cross-sectional study of 164 patients with primary open-angle glaucoma (POAG) were separated into moderate and advanced glaucoma groups. Definitions of moderate and advanced POAG were derived from International Geographical and Epidemiologic Ophthalmology criteria and included clinical assessment of optic disc atrophy and Humphrey automated perimetry. Data were collected at the patient’s first visit prior to initiation of therapy. Eligible POAG patients included those ≥30 years old with reliable Humphrey visual field (HVF) results, no past POAG diagnosis, treatment, or evidence of a secondary cause for glaucoma. Main outcome measures included comparisons of intraocular pressure (IOP), cup-to-disk ratio (CDR), best corrected visual acuity (VA), age, Humphrey mean deviation (MD), and pattern standard deviation (PSD).

Results

Of 164 charts reviewed, 90 (54.9%) advanced and 74 (45.1%) moderate POAG patients were compared. Mean age was 59.36 versus 55.53 years, respectively. Significant differences in IOP, CDR, CDR asymmetry, and HVF results were described. IOP > 30 mmHg was associated with CDR > 0.7 and MD greater than −12 dB in both eyes.

Conclusion

Significant differences were found between IOP, CDR, MD and PSD values. HVF is predictive of pretreated IOP, CDR, and severity of POAG and it is strongly encouraged as part of the standard glaucoma work up in all Ghanaian patients.

Keywords:

• glaucoma
• intraocular pressure
• Ghana

Acknowledgments

An International Health Research Scholarship from Boston University School of Medicine, Boston, MA, 2009 and The Massachusetts Lions Eye Research Fund to Boston University provided funding/support. Design of the study (AF, MG, HG); conduct of the study (AF, MG); collection of data (AF, MG); management of data (AF, MG); analysis of data (AF, LD); interpretation of data (AF, MG, LD, HG); preparation, review and approval of the manuscript (AF, MG, LD, HG). This manuscript has not previously been published and is an original manuscript. The corresponding author had full access to all the data in the study and takes responsibility for the integrity and accuracy of the data and its analysis as well as the decision to submit for publication. This retrospective study is in accordance with Health Insurance Portability and Accountability Act regulations and followed the tenets of the Declaration of Helsinki and received an exemption from an institutional review board (IRB) review in accordance with the following IRB criteria: B1.

Disclosure

There are no conflicts of interest associated with this work. The authors have no proprietary or commercial interest in any materials discussed in this article.