Glaucoma and intraocular pressure in EPIC-Norfolk Eye Study : cross sectional study
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Objectives : To report the distribution of intraocular pressure (IOP) by age and sex and the prevalence of glaucoma. Design: Community based cross sectional observational study. Setting: EPIC-Norfolk cohort in Norwich and the surrounding rural and urban areas. Participants: 8623 participants aged 48-92 recruited from the community who underwent ocular examination to identify glaucoma. Main outcome measures: Prevalence and characteristics of glaucoma, distribution of IOP, and the sensitivity and specificity of IOP for case finding for glaucoma. Results: The mean IOP in 8401 participants was 16.3 mm Hg (95% confidence interval 16.2 mm Hg to 16.3 mm Hg; SD 3.6 mm Hg). In 363 participants (4%), glaucoma was present in either eye; 314 (87%) had primary open angle glaucoma. In the remaining participants, glaucoma was suspected in 607 (7%), and 863 (10.0%) had ocular hypertension. Two thirds (242) of those with glaucoma had previously already received the diagnosis. In 76% of patients with newly diagnosed primary open angle glaucoma (83/107), the mean IOP was under the threshold for ocular hypertension (21 mm Hg). No one IOP threshold provided adequately high sensitivity and specificity for diagnosis of glaucoma. Conclusions: In this British community, cases of glaucoma, suspected glaucoma, and ocular hypertension represent a large number of potential referrals to the hospital eye service. The use of IOP for detection of those with glaucoma is inaccurate and probably not viable.
Chan , M P Y , Broadway , D C , Khawaja , A P , Yip , J L Y , Garway-Heath , D F , Burr , J M , Luben , R , Hayat , S , Dalzell , N , Khaw , K-T & Foster , P J 2017 , ' Glaucoma and intraocular pressure in EPIC-Norfolk Eye Study : cross sectional study ' , BMJ , vol. 358 , j3889 . https://doi.org/10.1136/bmj.j3889
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DescriptionEPIC-Norfolk infrastructure and core functions are supported by grants from the Medical Research Council (G0401527) and Cancer Research UK (C864/A8257). The clinic for the third health examination was funded by Research into Ageing (262). MPYC was supported by a joint Medical Research Council/Royal College of Ophthalmologists clinical training fellowship (G1001939/1) and the International Glaucoma Association. APK was a Wellcome Trust clinical research fellow (094791Z/10/Z). DGH, PJF, and JB were supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and University College London Institute of Ophthalmology, and PF received additional support from The Richard Desmond Charitable Trust.
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