JOURNAL READING

BY : KURNIA SARI, S.Ked (0110840044)

SUPERVISOR : dr. SARAH M. MANGGE. Sp.M

 FACT
THE RISK OF
VISUAL Open-angle
DISABILITY Glaucoma is the
second most glaucoma (OAG)
FROM is a major reason
GLAUCOMA ?? important reason
for blindness for blindness
worldwide
QUESTIONS FACT
 To determine the lifetime risk
and duration of blindness in
Purpose patients with manifest open-
angle glaucoma (OAG).

Retrospective chart review

Design
Most glaucoma patients living in the catchment area (city
of Malmo: n = 305 000) are managed at the Department of
Ophthalmology at Skane University Hospital in Malmo.

Glaucoma patients who died between January 2006 and

June 2010.

Eligible patients had to have OAG, primary open-angle

glaucoma (POAG), or exfoliative glaucoma (PEXG)

Patients included in the study were divided into 2 groups:

(1) diagnosis group; (2) follow-up only group
Diagnosis of Glaucoma
(1)
showed a repeatable visual eld defect (VFD)
consistent with glaucoma and not explained by
other causes

(2)
had only 1 visual eld test but with a VFD
consistent with glaucoma and a corresponding
optic disc abnormality

(3)
was already blind (visual acuity <0.05) at time of
diagnosis and had a record of a totally cupped
glaucomatous optic disc
 World Health Organization (WHO) criteria for low vision
(0.05 [20/400] VA < 0.3 [20/60] and/or 10 central VF < 20
degrees) and blindness (VA <0.05 [20/400] and/or central
VF <10 degrees).
 (2) bilateral low
vision: (3) unilateral
patients with low blindness: patients
vision in the best blind in 1 eye
eye

(4) bilateral
(1) unilateral low blindness:
vision: patients with both
patients with low eyes blind, mainly
vision in 1 eye 4 categories of caused by glaucoma
low vision and in at least 1 eye
blindness with
glaucoma as
the main cause:
 Median VA at time of diagnosis
was 0.8 (20/25), ranging from no
light perception to 1.00 (20/20)
Mean intraocular pressure (IOP)
value in all glaucomatous eyes at
time of diagnosis was 27.2 8.8
mmHg
 At the last visit, There was no Median time with a
42.2% (250 of 592 statistically signicant glaucoma diagnosis
patients) of all difference in the was 12 years.
frequencies of visual Median age when
patients were impairment at the last
blind from developing bilateral
visit when comparing blindness was 86
glaucoma in at the Data at Diagnosis years, and
least 1 eye and group and the Follow- Median duration of
16.4% (97 up Only group. bilateral blindness
patients) in both was 2 years.
eyes.
 IN THIS STUDY OF LIFETIME RISK FOR
BLINDNESS A LARGE proportion of
patients (42.2%) were blind from
glaucoma in at least 1 eye, and 16.4%
were bilaterally blind from glaucoma.
DISCUSSION The rates of low vision and blindness in
all included patients (n = 592). Access
to patient age, visual acuity (VA), and
visual elds (VF) as of the time of
diagnosis making it possible to
calculate the cumulative incidence of
blindness from glaucoma in this group
only.
 Approximately 1 out of 6 glaucoma
patients was bilaterally blind from
glaucoma at the last visit.
Median duration of bilateral blindness
was 2 years.
With longer life expectancy, glaucoma
patients will have the disease for a longer
time and it is possible that the lifetime
risk of glaucoma blindness may increase
even further.
THANK
YOU