Incidence of primary open angle glaucoma in the Andhra Pradesh Eye Disease Study (APEDS)

Nikhil S Choudhari; Rohit C Khanna; Srinivas Marmamula; Asha Latha Mettla; Pyda Giridhar; Seema Banerjee; Konegari Shekhar; Subhabrata Chakrabarti; Gudlavalleti V S Murthy; Clare Gilbert; Gullapalli N Rao; Andhra Pradesh Eye Disease Study Group

doi:10.1038/s41433-023-02799-z

Incidence of primary open angle glaucoma in the Andhra Pradesh Eye Disease Study (APEDS)

Eye (Lond). 2023 Nov 15. doi: 10.1038/s41433-023-02799-z. Online ahead of print.

Authors

Nikhil S Choudhari^{1

2}, Rohit C Khanna^{3

4

5

6}, Srinivas Marmamula^{2

7

8}, Asha Latha Mettla^{2

7}, Pyda Giridhar^{2

7}, Seema Banerjee^{2

7}, Konegari Shekhar^{2

7}, Subhabrata Chakrabarti⁷, Gudlavalleti V S Murthy^{9

10}, Clare Gilbert¹⁰, Gullapalli N Rao^{2

7}; Andhra Pradesh Eye Disease Study Group

Collaborators

Andhra Pradesh Eye Disease Study Group:
Maneck Nicholson, J V Raghava, T Sahitya, E Y Lavanya, Hira B Pant, Ritu Dixit, Goutham Pyatla, Alice Arati Anthony, Syed Hameed, Samir Bera, Sneha Kumari, Inderjeet Kaur

Affiliations

¹ VST Glaucoma Centre, Dr. Kallam Anji Reddy Campus, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India.
² Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India.
³ Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India. rohit@lvpei.org.
⁴ Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India. rohit@lvpei.org.
⁵ School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia. rohit@lvpei.org.
⁶ School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA. rohit@lvpei.org.
⁷ Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India.
⁸ Department of Biotechnology/ Wellcome Trust India Alliance, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India.
⁹ Indian Institute of Public Health, Madhapur, Hyderabad, India.
¹⁰ International Centre for Eye Health, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.

PMID: 37968514
DOI: 10.1038/s41433-023-02799-z

Abstract

Background: To report 15-year incidence rate of primary open angle glaucoma (POAG) in the Andhra Pradesh Eye Disease Study (APEDS).

Methods: A population-based longitudinal study was carried out at three rural study sites. Phakic participants aged ≥40 years who participated at baseline (APEDS I) and the mean 15-year follow-up visit (APEDS III) were included. A comprehensive ophthalmic examination was performed on all participants. Mean intraocular pressure (IOP) was average of IOPs of right and left eyes. The definition of glaucoma was based on the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification. The main outcome measure was incidence of POAG during the follow-up period in participants without glaucoma or suspicion of glaucoma at baseline.

Results: Data from the available and eligible participants from the original cohort (1241/2790; 44.4%) were analysed. The mean age (standard deviation) of participants at baseline was 50.2 (8.1) years; 580 (46.7%) were men. Thirty-six participants developed POAG [bilateral in 17 (47.2%)] over 15 years. The incidence rate of POAG per 100-person years (95% confidence interval) was 2.83 (2.6, 3.08). Compared to baseline, the reduction in mean IOP [median (range) mm Hg] was -0.75 (-7.5, 9) in participants with incident POAG and -2.5 (-14.5, 14.5) in those without. The inter-visit difference in mean IOP was a significant risk factor on logistic regression analysis.

Conclusion: We report the long-term incidence of POAG in rural India. A longitudinal change in IOP, specifically a less pronounced reduction in IOP with increasing age, was a novel risk factor.