Prevalence and Severity of Undetected Open-Angle Glaucoma in Persons 77 to 89 Years Old

PURPOSE: To determine the prevalence and severity of previously undetected open-angle glaucoma (OAG) in individuals aged 77 to 89 years in Malmö, Sweden. DESIGN: Cross-sectional study. SUBJECTS: All residents of Malmö, Sweden, aged 77 to 89 years were eligible for participation, except individuals with a prior glaucoma diagnosis at Skåne University Hospital. A total of 1957 individuals were invited, of whom 602 (30.8%) attended the screening. METHODS: The screening procedure included intraocular pressure measurement using an iCare tonometer, visual field screening using the Frequency Doubling Technology perimeter, and fundus photography. Subjects with positive screening results were offered a postscreening visit with a full ophthalmological examination, including threshold perimetry using the Swedish Interactive Threshold Algorithm Standard 24-2 program of the Humphrey Field Analyzer. The severity of disease was evaluated based on the perimetric mean deviation index. MAIN OUTCOME MEASURES: Prevalence of previously undetected OAG in individuals aged 77 to 89 years (%) and the magnitude of visual field defects expressed as proportions (%) of patients in 5 different disease severity stages. RESULTS: The prevalence of previously undetected OAG was 5.98% (95% confidence interval: 4.2%-8.2%), n = 35 patients. The condition was unilateral in 74% of patients. The severity of disease was early in 66% and moderate in 20%, while 14% of patients had advanced or severe disease. No patient had developed end-stage disease. The median intraocular pressure in glaucoma patients was 16 mmHg (interquartile range: 14-19 mmHg). CONCLUSIONS: The prevalence of previously undetected OAG was high in this age category, 5.98%, but most patients had early or moderate disease, and no patient had end-stage disease. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.