The prevalence of glaucomatous risk factors in patients from a managed care setting: a pilot evaluation.
OBJECTIVE
To report percentage of patients who present with glaucomatous risk factors (RFs) and determine average cumulative 5-year glaucoma progression risk in a subset of ocular hypertensive patients using the Ocular Hypertension Study (OHTS) predictive risk scoring system.


METHODS
A retrospective chart review of patients treated at a large ophthalmology clinic for International Classification of Diseases, Ninth Revision glaucoma-related diagnoses.


METHODS
Medical records were screened for demographic, clinical, and ocular RFs. Data were collected on ocular attributes, and descriptive, cross-tabulation, and regression statistics were applied to depict prevalence and potential influence of RFs. For the ocular hypertension subset, the OHTS risk scoring system calculated average cumulative 5-year risk of glaucoma conversion.


RESULTS
With 1189 eligible medical records available, univariate analyses demonstrated significant associations between older age and mean deviation (MD), vertical cup-to-disc ratio (CDR), intraocular pressure, and central corneal thickness (CCT). The presence of diabetes mellitus had a protective effect. Regression analyses identified age, mean CCT, and CDR as significant predictors of MD, whereas CCT was the strongest predictor of vertical CDR. Mean composite OHTS score was 9.7, signifying a 15% cumulative 5-year risk for developing glaucoma.


CONCLUSIONS
Known RFs were present in approximately one third of patients. Although analyses confirmed the predictive value of these RFs, existing models may not account for several important RFs or may rely on ocular metrics that might not be routinely or practically assessed in clinical practice. Additional studies are required to incorporate these considerations into future predictive models to enhance their clinical application and the interpretation of risk estimates.
Fang
Ervin N
EN
Southern California Kaiser Permanente Medical Group, 1515 N Vermont Ave, 7A, Los Angeles, CA 90027, USA. Ervin.n.Fang@KP.org
Law
Simon K
SK
Walt
John G
JG
Chiang
Tina H
TH
Williams
Erin N
EN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005901:Glaucoma / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D010865:Pilot Projects; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors