Nine-year incidence of open-angle glaucoma in the Barbados Eye Studies.
OBJECTIVE
To determine the 9-year incidence of open-angle glaucoma (OAG) in African-descent participants of the Barbados Eye Studies.


METHODS
Nine-year cohort study with 81% to 85% participation.


METHODS
Three thousand two hundred twenty-two persons without definite OAG at baseline, at risk of developing OAG at follow-up.


METHODS
The standardized protocol included automated perimetry and various ophthalmic measurements, with a comprehensive ophthalmologic examination for those referred. Fundus photographs were evaluated independently by masked graders. Incidence was estimated by the product-limit approach. Relative risk (RR) ratios with 95% confidence intervals (CIs) were based on Cox regression models with discrete time.


METHODS
Nine-year incidence of definite OAG, based on the development of visual field defects and glaucomatous optic neuropathy, with ophthalmologic confirmation.


RESULTS
The 9-year incidence of definite OAG was 4.4% (95% CI, 3.7%-5.2%), or an average of 0.5%/year, based on 125 new cases. Incidence increased greatly with age, from 2.2% at ages 40 to 49 years to 7.9% at ages 70 years or older, and tended to be higher in men than women (4.9% vs. 4.1%; RR, 1.3; 95% CI, 0.9-1.8). More than half (53%) of new cases were undetected, and of these, one third had intraocular pressure of 21 mmHg or less. When 141 persons developing suspected/probable OAG were considered, the total incidence was 9.4% (8.4%-10.6%), averaging approximately 1%/year, also increasing with age, and significantly higher in men than women (10.7% vs. 8.6%; RR, 1.31; 95% CI, 1.02-1.67).


CONCLUSIONS
These new data provide a measure of the long-term risk of OAG in an African-descent population, which is markedly higher than in persons of European ancestry. Results confirm the increased risk with age and in men. The incidence data fill a gap in our understanding of OAG risk and have implications for public health policy and planning; they also will allow the study of factors related to the risk of OAG development.
Leske
M Cristina
MC
Department of Preventive Medicine, Stony Brook University, Stony Brook, New York 11794-8036, USA. cleske@notes.cc.sunysb.edu
Wu
S Y
SY
Honkanen
R
R
Nemesure
B
B
Schachat
A
A
Hyman
L
L
Hennis
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001460:Barbados / Q000453:epidemiology; D044383:Black People / Q000208:ethnology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis; D058609:Visual Field Tests; D014794:Visual Fields