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Assessing Risks of Glaucoma

Oskarsdottir, Sigridur LU (2022) In Lund University, Faculty of Medicine Doctoral Dissertation Series
Abstract
Glaucoma is a potentially blinding disease where the affected individual often first
notices symptoms when the disease has reached a late stage. If glaucoma is detected
early e.g., at screening, the risk for visual impairment can be reduced. There are many
factors that affect a patient´s risk of developing glaucoma or visual impairment due to
glaucoma. In the four studies of this thesis, the general aim was to evaluate such factors, focussing mainly on age, intraocular pressure and severity at detection, to provide more information on the need for improved case detection.
The objectives of Study I and IV were to report the prevalence and severity of
undetected glaucoma in different age groups when detected at... (More)
Glaucoma is a potentially blinding disease where the affected individual often first
notices symptoms when the disease has reached a late stage. If glaucoma is detected
early e.g., at screening, the risk for visual impairment can be reduced. There are many
factors that affect a patient´s risk of developing glaucoma or visual impairment due to
glaucoma. In the four studies of this thesis, the general aim was to evaluate such factors, focussing mainly on age, intraocular pressure and severity at detection, to provide more information on the need for improved case detection.
The objectives of Study I and IV were to report the prevalence and severity of
undetected glaucoma in different age groups when detected at screening. Study I was
based on data originally collected in a large population screening for individuals 57-77 years old performed in 1992-1997. In Study IV, 322 elderly subjects 77-89 years old were screened for glaucoma in 2019-2021. We found that the prevalence of undetected glaucoma increased with age but disease severity was similar at 60-77 years of age with about 30% of glaucomatous eyes with advanced disease or worse, but mostly early in elderly patients 77-89 years old.
Using the large screening material from 1992-1997 that included 32,918 subjects, we
created a regression model for the prediction of undetected glaucoma based on the
combined effect of age and intraocular pressure (Study II). Glaucoma increased
exponentially with age and intraocular pressure.
Study III aimed to find the lifetime risk of glaucoma visual impairment in individuals
followed-up for raised intraocular pressure since the 1980s. We found that only 9% of
subjects developed bilateral visual impairment and 3% bilateral blindness resulting
from glaucoma.
The results are of value when estimating the need for improved glaucoma detection and when considering the management of patients with raised intraocular pressure. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Docent Harju, Mika, University of Helsinki
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Glaucoma, Glaucoma stages, Ocular hypertension, Prevalence, Visual impairment, Prediction model, Lifetime risk, Undetected glaucoma, Screening
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
issue
2022:26
pages
68 pages
publisher
Lund University, Faculty of Medicine
defense location
Agardh föreläsningssal, CRC, Jan Waldenströms gata 35, Skånes Universitetssjukhus i Malmö. Join by Zoom: https://lu-se.zoom.us/j/65983316806
defense date
2022-03-11 13:00:00
ISSN
1652-8220
ISBN
978-91-8021-187-1
language
English
LU publication?
yes
id
9cf0a8ba-fd46-4152-8ef8-3c1b99e70abc
date added to LUP
2022-02-10 18:26:38
date last changed
2022-02-18 14:25:57
@phdthesis{9cf0a8ba-fd46-4152-8ef8-3c1b99e70abc,
  abstract     = {{Glaucoma is a potentially blinding disease where the affected individual often first<br/>notices symptoms when the disease has reached a late stage. If glaucoma is detected<br/>early e.g., at screening, the risk for visual impairment can be reduced. There are many<br/>factors that affect a patient´s risk of developing glaucoma or visual impairment due to<br/>glaucoma. In the four studies of this thesis, the general aim was to evaluate such factors, focussing mainly on age, intraocular pressure and severity at detection, to provide more information on the need for improved case detection.<br/>The objectives of Study I and IV were to report the prevalence and severity of<br/>undetected glaucoma in different age groups when detected at screening. Study I was<br/>based on data originally collected in a large population screening for individuals 57-77 years old performed in 1992-1997. In Study IV, 322 elderly subjects 77-89 years old were screened for glaucoma in 2019-2021. We found that the prevalence of undetected glaucoma increased with age but disease severity was similar at 60-77 years of age with about 30% of glaucomatous eyes with advanced disease or worse, but mostly early in elderly patients 77-89 years old.<br/>Using the large screening material from 1992-1997 that included 32,918 subjects, we<br/>created a regression model for the prediction of undetected glaucoma based on the<br/>combined effect of age and intraocular pressure (Study II). Glaucoma increased<br/>exponentially with age and intraocular pressure.<br/>Study III aimed to find the lifetime risk of glaucoma visual impairment in individuals<br/>followed-up for raised intraocular pressure since the 1980s. We found that only 9% of<br/>subjects developed bilateral visual impairment and 3% bilateral blindness resulting<br/>from glaucoma.<br/>The results are of value when estimating the need for improved glaucoma detection and when considering the management of patients with raised intraocular pressure.}},
  author       = {{Oskarsdottir, Sigridur}},
  isbn         = {{978-91-8021-187-1}},
  issn         = {{1652-8220}},
  keywords     = {{Glaucoma; Glaucoma stages; Ocular hypertension; Prevalence; Visual impairment; Prediction  model; Lifetime risk; Undetected glaucoma; Screening}},
  language     = {{eng}},
  number       = {{2022:26}},
  publisher    = {{Lund University, Faculty of Medicine}},
  school       = {{Lund University}},
  series       = {{Lund University, Faculty of Medicine Doctoral Dissertation Series}},
  title        = {{Assessing Risks of Glaucoma}},
  url          = {{https://lup.lub.lu.se/search/files/113941621/Sgridur_OskarsdottirUtanManuscript.pdf}},
  year         = {{2022}},
}