TY - JOUR
T1 - Overdiagnosis of open-angle glaucoma in the general population
T2 - the Thessaloniki Eye Study
AU - Founti, Panayiota
AU - Coleman, Anne L.
AU - Wilson, M. Roy
AU - Yu, Fei
AU - Anastasopoulos, Eleftherios
AU - Harris, Alon
AU - Pappas, Theofanis
AU - Koskosas, Archimidis
AU - Kilintzis, Vassilis
AU - Salonikiou, Angeliki
AU - Raptou, Anastasia
AU - Topouzis, Fotis
N1 - Publisher Copyright:
© 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
PY - 2018/11
Y1 - 2018/11
N2 - Purpose: To assess the overdiagnosis of open-angle glaucoma (OAG) and to investigate associated factors. Methods: This was a cross-sectional, population-based study of an urban Caucasian population in northern Greece. Randomly selected subjects ≥60 years (n = 2554) participated in the Thessaloniki Eye Study. The definition of OAG required the presence of structural and functional damage, irrespective of intraocular pressure (IOP). Non-OAG subjects were classified as overdiagnosed with OAG if they had reported at least one of the following (self-reported glaucoma): (i) prior diagnosis of glaucoma, (ii) prior laser for glaucoma, (iii) prior glaucoma surgery. Factors associated with the overdiagnosis of OAG were investigated using a logistic regression model. Results: Of 57 (2.2%) subjects with self-reported glaucoma, 34 (60%) were overdiagnosed with OAG, corresponding to a prevalence of 1.3% (34/2554). In a logistic regression model among non-OAG subjects, worse visual acuity (VA) (20/200 or worse versus 20/25 or better; odds ratio (OR) = 4.30, 95% Confidence Intervals (CI), 1.13–16.35), family history of glaucoma (OR = 8.69, 95% CI, 2.83–26.67) and history of cataract surgery (OR = 11.50, 95% CI, 3.85–34.36) were statistically significantly associated with the overdiagnosis of OAG. Age, sex, higher IOP, higher vertical cup-to-disc ratio and pseudoexfoliation were not statistically significant. Conclusion: The overdiagnosis of OAG was substantial in this elderly, Caucasian population. The overdiagnosis of glaucoma has not been previously addressed in population-based studies and needs to be further explored.
AB - Purpose: To assess the overdiagnosis of open-angle glaucoma (OAG) and to investigate associated factors. Methods: This was a cross-sectional, population-based study of an urban Caucasian population in northern Greece. Randomly selected subjects ≥60 years (n = 2554) participated in the Thessaloniki Eye Study. The definition of OAG required the presence of structural and functional damage, irrespective of intraocular pressure (IOP). Non-OAG subjects were classified as overdiagnosed with OAG if they had reported at least one of the following (self-reported glaucoma): (i) prior diagnosis of glaucoma, (ii) prior laser for glaucoma, (iii) prior glaucoma surgery. Factors associated with the overdiagnosis of OAG were investigated using a logistic regression model. Results: Of 57 (2.2%) subjects with self-reported glaucoma, 34 (60%) were overdiagnosed with OAG, corresponding to a prevalence of 1.3% (34/2554). In a logistic regression model among non-OAG subjects, worse visual acuity (VA) (20/200 or worse versus 20/25 or better; odds ratio (OR) = 4.30, 95% Confidence Intervals (CI), 1.13–16.35), family history of glaucoma (OR = 8.69, 95% CI, 2.83–26.67) and history of cataract surgery (OR = 11.50, 95% CI, 3.85–34.36) were statistically significantly associated with the overdiagnosis of OAG. Age, sex, higher IOP, higher vertical cup-to-disc ratio and pseudoexfoliation were not statistically significant. Conclusion: The overdiagnosis of OAG was substantial in this elderly, Caucasian population. The overdiagnosis of glaucoma has not been previously addressed in population-based studies and needs to be further explored.
KW - epidemiology
KW - open-angle glaucoma
KW - overdiagnosis
KW - population-based study
UR - http://www.scopus.com/inward/record.url?scp=85052954496&partnerID=8YFLogxK
U2 - 10.1111/aos.13758
DO - 10.1111/aos.13758
M3 - Article
C2 - 30178607
AN - SCOPUS:85052954496
SN - 1755-375X
VL - 96
SP - e859-e864
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
IS - 7
ER -