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Br J Ophthalmol 2003;87:1069-1074 doi:10.1136/bjo.87.9.1069
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Prevalence of glaucoma in Thailand: a population based survey in Rom Klao District, Bangkok

  1. R R A Bourne1,
  2. P Sukudom2,
  3. P J Foster1,
  4. V Tantisevi2,
  5. S Jitapunkul3,
  6. P S Lee1,
  7. G J Johnson1,
  8. P Rojanapongpun2
  1. 1Department of Epidemiology and International Eye Health, Institute of Ophthalmology, University College London, London, UK
  2. 2Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
  3. 3Department of Geriatric Medicine, Division of Medicine, Chulalongkorn University, Bangkok, Thailand
  1. Correspondence to: Dr Rupert Bourne, Department of Epidemiology and International Eye Health, Institute of Ophthalmology, 11-43 Bath Street, London EC1V 5EL, UK; rupert_bourne{at}hotmail.com
  • Accepted 26 February 2003

Abstract

Aim: To determine prevalence, demography, mechanism, and visual morbidity of glaucoma in urban Thai people.

Methods: 790 subjects aged 50 years or older from Rom Klao district, Bangkok, Thailand, were enumerated in a population based cross sectional study. Each subject underwent the following investigations: visual acuity, visual field testing, slit lamp examination, applanation tonometry, gonioscopy, and an optic disc examination after mydriasis. Main outcome measures included visual acuity (logMAR), visual fields, intraocular pressure (IOP), gonioscopic characteristics, vertical cup/disc ratio (VCDR), prevalence of types of glaucoma. Glaucoma was diagnosed on the basis of optic disc appearance and visual field defects. In eyes in which the optic disc could not be examined, glaucoma was diagnosed when visual acuity was <3/60 and either IOP >99.5th percentile or there was evidence of previous glaucoma surgery.

Results: 701 subjects were examined (response rate 88.7%). In eyes with “normal” suprathreshold visual fields, the mean IOP was 13.3 mm Hg (97.5th percentile = 20 mm Hg). The 97.5th and 99.5th percentiles of VCDR were 0.72 and 0.86 respectively. Of the 701 subjects examined in the clinic, 27 had glaucoma (3.8%, 95% CI: 2.5 to 5.6), 16 had primary open angle glaucoma (POAG, prevalence 2.3%, 95% CI: 1.3 to 3.7), six were primary angle closure glaucoma (PACG, prevalence 0.9%, 95% CI: 0.3 to 1.9), and five were secondary glaucoma (SecG, prevalence 0.7%, 95% CI: 0.2 to 1.7). Among the 43 unilaterally blind subjects, glaucoma was the cause in five subjects (12%). One subject was bilaterally blind due to glaucoma (prevalence 11%, 95% CI: 0.3 to 61.9). 28 people (4%) were glaucoma suspects on the basis of optic disc appearance and six on the basis of visual fields only. 98 subjects (14%) had “occludable angles” in either eye, 22 of whom had primary angle closure (PAC, prevalence 3.1%, 95% CI: 1.9 to 4.7); 14 had peripheral anterior synechiae in either eye and eight had ocular hypertension (OHT).

Conclusions: POAG accounted for 67% of all glaucoma, PACG 21%, and secondary glaucomas 12%. Glaucoma was the second most common cause of severe unilateral visual loss.

Footnotes

  • Presented in part at The Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, May 2001.

  • Funded by the British Council for the Prevention of Blindness, London, UK, and the Glaucoma Research Fund, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand. The authors have no financial interests related to this manuscript.

  • Series editors: W V Good, S Ruit

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