title: Presentation of glaucoma in the greater Accra metropolitan area of Ghana.
abstract: BACKGROUND
  This study addresses the prevalence and clinical presentation of patients with primary open angle glaucoma (POAG) in the greater Accra metropolitan area.
  
  
  METHODS
  This is a retrospective case series of 455 patients (813 eyes) at the Emmanuel Eye Clinic. Patients were diagnosed from May 2008 to Nov 2011. The definition of POAG conformed to the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Information collected included basic demographic data, distribution of glaucoma subtypes, measured intraocular pressure (IOP), best corrected visual acuity (BCVA) and optic disc measurements.
  
  
  RESULTS
  Nearly 24% presented blind in at least one eye. The average age was 56.7 +/-16.7 years and the average IOP was 33.9 mmHg +/- 12.7 mmHg for right eyes and 33.5 mmHg +/-12.0 mmHg for left eyes. The mean vertical cup to disc ratio (vCDR) was 0.83 for right eyes versus 0.82 for left eyes. A total of 32 patients (53 eyes) were diagnosed with normal tension glaucoma (NTG). Statistically significant differences between the NTG and high tension groups included age (45.3 +/- 16.7 vs. 56.7 +/-16.7, p<0.001), mean IOP (19.1 mmHg +/- 4.5 mmHg vs. 33.7 +/- 12.4 mmHg, p<0.001) and mean vCDR (0.76 +/- 0.17 vs. 0.83 +/-0.10, p<0.01). Comparing age-matched NTG patients with high tension glaucoma patients showed no significant difference in vCDR.
  
  
  CONCLUSIONS
  The clinical presentation of POAG at the Emmanuel Eye Center is characterized by elevated IOP and grossly advanced optic neuropathy. Significant differences between high tension glaucoma and NTG were identified.
authors.affiliation: Emmanuel Eye Centre, Accra, Ghana.
authors.forename: M E
authors.initials: ME
authors.lastname: Gyasi
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine at Chicago, Chicago, IL, USA.
authors.forename: A W
authors.initials: AW
authors.lastname: Francis
authors.affiliation: Yale University, New Haven, Connecticut, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Royal United Hospital Bath NHS Trust, United Kingdom.
authors.forename: R S R
authors.initials: RS
authors.lastname: Harrison
authors.affiliation: Emmanuel Eye Centre, Accra, Ghana.
authors.forename: A R
authors.initials: AR
authors.lastname: Kodjo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000209:etiology; D002940:Circadian Rhythm; D002947:Cities / Q000453:epidemiology; D005260:Female; D005869:Ghana / Q000453:epidemiology; D005902:Glaucoma, Open-Angle / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009898:Optic Disk; D015995:Prevalence; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult
keywords: Accra; Africa; Ghana; Normal Tension Glaucoma; Primary Open Angle Glaucoma