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Risk factors for previously undiagnosed primary open-angle glaucoma: the EPIC-Norfolk Eye Study

Chan, MPY; Khawaja, AP; Broadway, DC; Yip, J; Luben, R; Hayat, S; Peto, T; ... Foster, PJ; + view all (2021) Risk factors for previously undiagnosed primary open-angle glaucoma: the EPIC-Norfolk Eye Study. British Journal of Ophthalmology 10.1136/bjophthalmol-2020-317718. (In press). Green open access

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Abstract

BACKGROUND AND AIM: Undiagnosed glaucoma is an invisible but important public health issue. At least half of glaucoma cases are estimated to be undiagnosed in western populations. The aim of this study is to examine risk factors for previously undiagnosed primary open-angle glaucoma (POAG). DESIGN: Cross-sectional study within the European Prospective Investigation of Cancer-Norfolk Eye Study, a large-scale cohort study in the UK. PARTICIPANTS: 314 study participants with POAG in either eye. METHODS: Logistic regression was used to examine associations with previously undiagnosed POAG compared with previously diagnosed POAG. The factors examined included sociodemographic, ocular, physical and economic factors that could be barriers to eye care access. RESULTS: 217 participants had previously diagnosed POAG and 107 participants were newly diagnosed with POAG during the study. After adjusting for covariables, the factors significantly associated with previously undiagnosed POAG were: a lower pretreatment intraocular pressure (IOP) (OR 0.71/mm Hg, 95% CI 0.63 to 0.80, p<0.0001), and to have reported no problems with their eyesight (OR 0.03, 95% CI 0.01 to 0.10, p<0.0001). CONCLUSIONS: The risk factors for previously undiagnosed POAG identified in this study highlight the over-reliance on IOP level in glaucoma screening and the risk of missing glaucoma among lower IOP cases. It also suggests a role in improving glaucoma awareness in the community.

Type: Article
Title: Risk factors for previously undiagnosed primary open-angle glaucoma: the EPIC-Norfolk Eye Study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bjophthalmol-2020-317718
Publisher version: http://dx.doi.org/10.1136/bjophthalmol-2020-317718
Language: English
Additional information: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10130417
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