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

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Michelle P. Y. Chan, David C. Broadway, Anthony P. Khawaja, Jennifer L. Y. Yip, David F. Garway-Heath, Jennifer M. Burr, Robert Luben, Shabina Hayat, Nichola Dalzell, Kay-Tee Khaw, Paul J. Foster

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Abstract

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.
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Original languageEnglish
Article numberj3889
Number of pages7
JournalBMJ
Volume358
DOIs
Publication statusPublished - 13 Sep 2017

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