Prevalence of open-angle glaucoma in Iceland: Reykjavik Eye Study

Purpose To establish the age- and sex-specific prevalence of open-angle glaucoma (OAG) subsuming pseudoexfoliation (PEX) in the city of Reykjavik. Methods Participants 50 years of age and older who were part of the Reykjavik Eye Study and classified as having glaucoma were divided into three categories: Category 1: two or more of the following based on optic nerve stereophotograph reading: vertical cup to disc ratio (VCDR) 97.5th percentile (>0.7), focal glaucomatous disc change, C/D asymmetry of 97.5th percentile difference between eyes (>0.2) as well as glaucomatous visual field defect (GVFD). Category 2: 99.5th percentile of VCDR (>0.8) and 99.5% percentile difference between eyes (greater than or equal to0.3), without a GVFD. Category 3: VA <3/60 and IOP >99.5th percentile or VA <3/60 and evidence of filtering surgery. For a glaucoma suspect, one of the following was present: VCDR >99.5th percentile (>0.8), focal glaucomatous disc change, C/D asymmetry of 99.5th percentile (greater than or equal to0.3), GVFD only, IOP greater than or equal to 23 mmHg (97.5 percentile). PEX was diagnosed by the presence of a central shield and/or a peripheral band on the anterior lens capsule. Results Of 42 persons ( 22 males and 20 females) with OAG, 13 (31.0%) had PEX. The minimum prevalence of OAG was 4.0% (42/1045) (95% CI 2.8 - 5.2) for those 50 years and older and 10.3% ( 95% CI 8.5 - 12.2) for PEX. The prevalence of OAG increases with age ( OR = 1.10/year, 95% CI 1.07 - 1.13, P = 0.000) and the same applies for the prevalence of PEX, OR = 1.10 ( 95% CI 1.07 - 1.12, P = 0.000). Conclusion There is a 10% annual increase for both OAG and PEX in persons 50 years and older.