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Population studies important, but should be defined when considering conclusions
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LAS VEGAS — The epidemiology of glaucoma may help physicians understand both the disease and people at risk of developing the disease, said Eve J. Higginbotham, MD, here at the First Annual Ocular Surgery News Symposium — Glaucoma: Improving Your Odds.
“Certainly, we don’t know everything about glaucoma,” Dr. Higginbotham said. “That is why we are here today and we will hear more questions than answers. But we will hear about the patterns of glaucoma that will help us determine who is at risk for glaucoma.”
She noted 67 million people worldwide have some form of glaucoma and that the disease has been recognized as an independent risk factor in serious motor vehicle accidents. In addition, the Olmstead County (Minn.) study results showed that despite treatment, 9% of patients with glaucoma had the disease progress.
Large cohort studies have sought to clarify which members of a population are at risk for glaucoma, but each study has had different parameters.
“Locations are disparate; the criteria, age, ethnicity and prevalence all differed,” Dr. Higginbotham said. “So there is going to be a wide range of reports.”
Still risk factors for primary angle-closure glaucoma have emerged – ethnicity, age, gender should all be considered, as well as hyperopia and a positive family history. Even climate should be considered.
Intraocular pressure is a significant risk factor for primary open-angle glaucoma (POAG) according to the Baltimore Eye Survey. Age is a significant risk factor when comparing 70-to-79 year olds vs. 40-to-49 year olds, she said. Gender studies have shown high risk factors for males, females or no difference, depending on the study. Ethnicity, family history and diabetes are also risk factors.
For POAG, there is no consensus on the risk of glaucoma based upon systemic hypertension, myopia, migraines and thyroid disease.
“Why study epidemiology? It is important to recognize these patterns of disease,” she said. “However, when we look at a patient in our office, the person in front of us may not represent a study. Age and family history are clearly supported as risk factors. Genetic analyses will undoubtedly reshape our consideration of race and ethnicity in the future.”