Glaucoma and intraocular pressure in EPIC-Norfolk Eye Study: cross sectional study

Objectives To report the distribution of intraocular pressure (IOP) by age and sex and the prevalence of glaucoma.Design Community based cross sectional observational study.Setting EPIC-Norfolk cohort in Norwich and the surrounding rural and urban areas.Participants 8623 participants aged 48-92 recr...

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Bibliographic Details
Published in:BMJ (Online) 2017-09, Vol.358, p.j3889-j3889
Main Authors: Chan, Michelle P Y, Broadway, David C, Khawaja, Anthony P, Yip, Jennifer L Y, Garway-Heath, David F, Burr, Jennifer M, Luben, Robert, Hayat, Shabina, Dalzell, Nichola, Khaw, Kay-Tee, Foster, Paul J
Format: Article
Language:English
Subjects:
Age
Age Distribution
Aged
Aged, 80 and over
Appointments & personnel changes
Cancer
Cross-Sectional Studies
Diabetic retinopathy
Eye
Female
Glaucoma
Glaucoma - diagnosis
Glaucoma - epidemiology
Humans
Hypertension
Intraocular Pressure
Male
Middle Aged
Population
Prevalence
Sensitivity and Specificity
Sex Distribution
Tonometry, Ocular - methods
Tonometry, Ocular - statistics & numerical data
United Kingdom - epidemiology
Womens health
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Summary:Objectives To report the distribution of intraocular pressure (IOP) by age and sex and the prevalence of glaucoma.Design Community based cross sectional observational study.Setting EPIC-Norfolk cohort in Norwich and the surrounding rural and urban areas.Participants 8623 participants aged 48-92 recruited from the community who underwent ocular examination to identify glaucoma.Main outcome measures Prevalence and characteristics of glaucoma, distribution of IOP, and the sensitivity and specificity of IOP for case finding for glaucoma.Results The mean IOP in 8401 participants was 16.3 mm Hg (95% confidence interval 16.2 mm Hg to 16.3 mm Hg; SD 3.6 mm Hg). In 363 participants (4%), glaucoma was present in either eye; 314 (87%) had primary open angle glaucoma. In the remaining participants, glaucoma was suspected in 607 (7%), and 863 (10.0%) had ocular hypertension. Two thirds (242) of those with glaucoma had previously already received the diagnosis. In 76% of patients with newly diagnosed primary open angle glaucoma (83/107), the mean IOP was under the threshold for ocular hypertension (21 mm Hg). No one IOP threshold provided adequately high sensitivity and specificity for diagnosis of glaucoma.Conclusions In this British community, cases of glaucoma, suspected glaucoma, and ocular hypertension represent a large number of potential referrals to the hospital eye service. The use of IOP for detection of those with glaucoma is inaccurate and probably not viable.
ISSN:0959-8138
1756-1833
DOI:10.1136/bmj.j3889