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Abstract #55778 Published in IGR 15-4
Long-term trends in glaucoma-related blindness in olmsted county, Minnesota
Malihi M; Moura Filho ER; Hodge DO; Sit AJOphthalmology 2014; 121: 134-141
See also comment(s) by David Friedman • Kaweh Mansouri •
OBJECTIVE: To determine the longitudinal trends in the probability of blindness due to open-angle glaucoma (OAG) in Olmsted County, Minnesota, from 1965 to 2009. DESIGN: Retrospective, population-based cohort study. PARTICIPANTS: All residents of Olmsted County, Minnesota (aged ≥40 years) who were diagnosed with OAG between January 1, 1965, and December 31, 2000. METHODS: All available medical records of every incident case of OAG were reviewed until December 31, 2009, to identify progression to blindness, defined as visual acuity ≤20/200 or visual field constriction to ≤20°. Kaplan-Meier analysis was used to estimate the cumulative probability of glaucoma-related blindness. Population incidence of blindness within 10 years of diagnosis was calculated using US Census data. Rates for subjects diagnosed in the period 1965-1980 were compared with rates for subjects diagnosed in the period 1981-2000 using log-rank tests and Poisson regression models. MAIN OUTCOME MEASURES: Cumulative probability of OAG-related blindness and population incidence of blindness within 10 years of diagnosis. RESULTS: Probability of glaucoma-related blindness in at least 1 eye at 20 years decreased from 25.8% (95% confidence interval [CI], 18.5-32.5) for subjects diagnosed in 1965-1980 to 13.5% (95% CI, 8.8-17.9) for subjects diagnosed in 1981-2000 (P = 0.01). The population incidence of blindness within 10 years of the diagnosis decreased from 8.7 per 100 000 (95% CI, 5.9-11.5) for subjects diagnosed in 1965-1980 to 5.5 per 100 000 (95% CI, 3.9-7.2) for subjects diagnosed in 1981-2000 (P = 0.02). Higher age at diagnosis was associated with increased risk of progression to blindness (P < 0.001). CONCLUSIONS: The 20-year probability and the population incidence of blindness due to OAG in at least 1 eye have decreased over a 45-year period from 1965 to 2009. However, a significant proportion of patients still progress to blindness despite recent diagnostic and therapeutic advancements.
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Classification:
1.5 Glaucomas as cause of blindness (Part of: 1 General aspects)