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1 General aspects (0)   1.1 Epidemiology (7)   1.2 Population genetics (0)   1.3 Pathogenesis (4)   1.4 Quality of life (8)   1.5 Glaucomas as cause of blindness (5)   1.6 Prevention and screening (8) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (6)   2.2 Cornea (14)   2.3 Sclera (3)   2.4 Anterior chamber angle (3)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (6)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (4)       2.6.2.2 Uveoscleral (1)     2.6.3 Compostion (0)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (3)   2.9 Ciliary body (6)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (0)   2.13 Retina and retinal nerve fibre layer (21)   2.14 Optic disc (17)   2.15 Optic nerve (5)   2.16 Chiasma and retrochiasmal central nervous system (4)   2.17 Stem cells (1)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (1)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (3)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (2)     3.4.2 Gene studies (16)   3.5 Molecular biology incl. SiRNA (12)   3.6 Cellular biology (21)   3.7 Biochemistry (0)   3.8 Pharmacology (8)   3.9 Pathophysiology (8)   3.10 Immunobiology (4)   3.11 Pharmacogenetics (0)   3.12 Proteomics (1)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (4)     3.13.4 Other (0)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (0)   5.1 Rodent (27)   5.2 Primates (3)   5.3 Other (9) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (0)     6.1.1 Devices, techniques (8)     6.1.2 Fluctuation, circadian rhythms (6)     6.1.3 Factors affecting IOP (6)   6.2 Tonography, aqueous flow measurement (see also 2.6) (0)   6.3 Biomicroscopy (slitlamp) (1)     6.3.1 Anterior segment (0)     6.3.2 Posterior segment (0)   6.4 Gonioscopy (1)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (0)     6.6.2 Automated (16)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (6)   6.7 Electro-ophthalmodiagnosis (3)   6.8 Photography (0)     6.8.1 Anterior segment (2)     6.8.2 Posterior segment (8)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (0)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (13)       6.9.1.2 Confocal Scanning Laser Polarimetry (7)     6.9.2 Optical coherence tomography (0)       6.9.2.1 Anterior (3)       6.9.2.2 Posterior (22)     6.9.5 Other (0)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (0)   6.11 Bloodflow measurements (27)   6.12 Ultrasonography and ultrasound biomicroscopy (6)   6.13 Provocative tests (3)   6.19 Telemedicine (0)   6.20 Progression (8)   6.30 Other (4) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (1)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (1) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (0)     9.1.1 Congenital glaucoma, Buphthalmos (6)     9.1.2 Juvenile glaucoma (10)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (2)     9.1.4 Other (0)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (0)     9.2.2 Other risk factors for glaucoma (4)     9.2.3 Open angle glaucoma with elevated IOP (1)     9.2.4 Normal pressure glaucoma (4)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (3)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (1)     9.3.3 Plateau iris syndrome (2)     9.3.4 Primary angle closure suspect (2)     9.3.5 Primary angle closure (4)     9.3.10 Other (1)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (6)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (1)       9.4.2.2 Posterior polymorphous dystrophy (1)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (1)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (2)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (11)       9.4.4.2 Glaucomas associated with cataracts (2)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (8)       9.4.5.5 Other (2)     9.4.6 Glaucomas associated with inflammation, uveitis (11)     9.4.7 Glaucomas associated with ocular trauma (3)     9.4.8 Glaucomas associated with intraocular tumors (1)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (1)       9.4.10 Glaucomas associated with hemorrhage (2)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (2)       9.4.11.2 Glaucomas in aphakia and pseudophakia (3)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (2)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (4)     9.4.15 Glaucoma in relation to systemic disease (17)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (3) 11 Medical treatment (0)   11.1 General management, indication (9)   11.2 Cholinergic drugs (2)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (2)     11.3.4 Betablocker (6)     11.3.5 Other (0)   11.4 Prostaglandins (16)   11.5 Carbonic anhydrase inhibitors (0)     11.5.1 Systemic (1)     11.5.2 Topical (1)   11.6 Osmotic treatment (0)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (21)   11.9 Gene therapy (1)   11.13 Combination therapy (2)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (5)     11.13.3 Betablocker and brimonidine (0)     11.13.4 Betablocker and prostaglandin (3)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (15)   11.15 Other drugs in relation to glaucoma (16)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (9)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (8)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (0)   12.2 Laser iridotomy (4)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (4)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (0)     12.8.1 Without tube implant (13)     12.8.2 With tube implant or other drainage devices (15)     12.8.3 Non-perforating (4)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (6)     12.8.11 Complications, endophthalmitis (8)   12.9 Trabeculotomy, goniotomy (2)   12.10 Cyclodestruction (2)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (1)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (2)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (2)   12.15 Capsulotomy (0)   12.16 Vitrectomy (2)   12.17 Anesthesia (1)   12.20 Other (1) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (1)   13.2 Outcome (0)     13.2.1 IOP (2)     13.2.2 Visual field (0)       13.2.2.1 Progression (2)       13.2.2.2 Improvement (1)     13.2.3 Other (1) 14 Costing studies; pharmacoeconomics (12) 15 Miscellaneous (31)

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Abstract #24981 Published in IGR 11-4

Glaucoma screening in Western Cameroon

Preussner PR; Grossmann A; Ngounou F; Kouogan G; Tamon J
Graefe's Archive for Clinical and Experimental Ophthalmology 2009; 247: 1671-1675

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PURPOSE: To quantify glaucoma-related parameters in a rural African region. MATERIAL AND METHOD: In a population-based investigation, 635 persons in six villages underwent slit-lamp examination including investigation of the optic nerve head with a 90D lens and Goldmann applanation tonometry. The mean age of the persons was 49.4 +/- 19 years, minimum 5, maximum 90, median 52 years. The inferior, superior, nasal and temporal margin width of the optic nerve head (ONH) were estimated as fractions of the total disk diameter, thus allowing the evaluation of the horizontal and vertical cup-disk ratio (CDR), the ratio of the elliptical cup area to the total disk area (area CDR), and violations of the ISNT rule (Inferior>or=Superior>or=Nasal>or=Temporal ONH rim). RESULTS: Area CDR significantly increased with age, on average from 0.1 in the youngest to 0.47 in the oldest person, corresponding to an increase of linear CDR from 0.32 to 0.68. The total fraction of eyes exceeding an area CDR of 0.5 (i.e. linear 0.7) was 13.4%. In addition, the intraocular pressure (IOP) increased on average from 14 mmHg in the youngest to 20 mmHg in the oldest persons, but nevertheless many high CDR values were found in eyes with normal to moderately elevated IOP. Violations of the ISNT rule were found in approximately 25% of the eyes. Application of a combination of glaucoma criteria as commonly used in literature resulted in a total prevalence of 18.7% of the screened persons, corresponding to a prevalence of 8.2% after age correction for the--on average--very young Cameroonian population. CONCLUSION: Compared to Europe, glaucoma prevalence appears to be nearly an order of magnitude higher in this rural African population.

University Eye Hospital, Langenbeckstr. 1, 55101 Mainz, Germany. pr.preussner@uni-mainz.de

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Classification:

1.6 Prevention and screening (Part of: 1 General aspects)

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