The prevalence of primary angle closure glaucoma in European derived populations: a systematic review
- Alexander C Day1,2,
- Gianluca Baio3,
- Gus Gazzard2,
- Catey Bunce1,2,4,
- Augusto Azuara-Blanco5,
- Beatriz Munoz6,
- David S Friedman6,
- Paul J Foster1,2
- 1Department of Genetics and Epidemiology, UCL Institute of Ophthalmology, London, UK
- 2NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, UK
- 3Department of Statistical Science, University College London, UK
- 4The London School of Hygiene and Tropical Medicine, UK
- 5Health Services Research Unit, University of Aberdeen, UK
- 6Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, USA
- Correspondence to Dr Alexander C Day, UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK;
Contributors ACD: Design, analysis and interpretation of data, drafting the article and final approval of the version to be published. GB: Design, analysis and interpretation of data and final approval of the version to be published. GG: Conception and design, analysis and interpretation of data and revising it critically for important intellectual content. CB: Analysis and interpretation of data and revising it critically for important intellectual content. AA-B: Design, analysis and interpretation of data and revising it critically for important intellectual content. BM and DF: Interpretation of data and revising it critically for important intellectual content. PJF: Conception and design, interpretation of data, revising it critically for important intellectual content and final approval of the version to be published.
- Accepted 29 April 2012
- Published Online First 31 May 2012
Aim To estimate the prevalence of primary angle closure glaucoma (PACG) in European derived populations.
Method Systematic review and modelling of PACG prevalence data from population studies. PACG was defined according to the ISGEO definition requiring structural and/or functional evidence of glaucomatous optic neuropathy. Prevalence estimates were applied to the 2010 United Nations projected population figures to estimate case numbers.
Results The prevalence of PACG in those 40 years or more is 0.4% (95% CI 0.3% to 0.5%). Age-specific prevalence values are 0.02% (CI 0.00 to 0.08) for those 40–49 years, 0.60% (0.27 to 1.00) for those 50–59 years, 0.20% (0.06 to 0.42) for those 60–69 years and 0.94% (0.63 to 1.35) for those 70 years and older. Three-quarters of all cases occur in female subjects (3.25 female to 1 male; CI 1.76 to 5.94).
Conclusion This analysis provides a current evidence-based estimate of PACG prevalence in European derived populations and suggests there are 130 000 people in the UK, 1.60 million people in Europe and 581 000 people in the USA with PACG today. Accounting for ageing population structures, cases are predicted to increase by 19% in the UK, 9% in Europe and 18% in the USA within the next decade. PACG is more common than previously thought, and all primary glaucoma cases should be considered to be PACG until the anterior chamber angle is shown to be open on gonioscopy.
- Angle closure glaucoma prevalence
- anterior chamber
- ciliary body
- intraocular pressure
- diagnostic tests/investigation
- treatment lasers
- clinical trial
- treatment surgery
- treatment medical
- field of vision
- optic nerve
- public health
An additional table is published online only. To view this file please visit the journal online (http://bjo.bmj.com).
Funding Funding for this project was provided by The RD Crusaders Charitable Trust (via Fight for Sight, London; grant reference 1956). Dr Day and Professor Foster acknowledge a proportion of their financial support from the Department of Health through the award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology. Dr Baio is partly funded by the Department of Health through the award made by the National Institute for Health Research to UCL. The Health Services Research Unit, University of Aberdeen, UK, is core funded by the Chief Scientist Office of the Scottish government Health Directorates (AAB). The views expressed in this manuscript are those of the authors and not necessarily those of the Department for Health.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.