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Alan L Robin - One of the best experts on this subject based on the ideXlab platform.
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glaucoma in a Rural Population of southern india the aravind comprehensive eye survey
Ophthalmology, 2003Co-Authors: R Ramakrishnan, Praveen K Nirmalan, R Krishnadas, R D Thulasiraj, Joanne Katz, James M Tielsch, David S Friedman, Alan L RobinAbstract:Abstract Purpose To determine the prevalence of glaucoma and risk factors for primary open-angle glaucoma in a Rural Population of southern India. Design A Population-based cross-sectional study. Participants A total of 5150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. Methods All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of the minimum angle of resolution illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Main outcome measures Definite primary open-angle glaucoma (POAG) was defined as angles open on gonioscopy and glaucomatous optic disc changes with matching visual field defects, whereas ocular hypertension was defined as intraocular pressure (IOP) greater than 21 mmHg without glaucomatous optic disc damage and visual field defects in the presence of an open angle. Manifest primary angle-closure glaucoma (PACG) was defined as glaucomatous optic disc damage or glaucomatous visual field defects with the anterior chamber angle partly or totally closed, appositional angle closure or synechiae in the angle, and absence of signs of secondary angle closure. Secondary glaucoma was defined as glaucomatous optic nerve damage and/or visual field abnormalities suggestive of glaucoma with ocular disorders that contribute to a secondary elevation in IOP. Results The prevalence (95% confidence interval) of any glaucoma was 2.6% (2.2, 3.0), of POAG it was 1.7% (1.3, 2.1), and if PACG it was 0.5% (0.3, 0.7), and secondary glaucoma excluding pseudoexfoliation was 0.3% (0.2,0.5). On multivariate analysis, increasing age, male gender, myopia greater than 1 diopter, and pseudoexfoliation were significantly associated with POAG. After best correction, 18 persons (20.9%) with POAG were blind in either eye because of glaucoma, including 6 who were bilaterally blind and an additional 12 persons with unilateral blindness because of glaucomatous optic neuropathy in that eye. Of those identified with POAG, 93.0% had not been previously diagnosed with POAG. Conclusions The prevalence of glaucoma in this Population is not lower than that reported for white Populations elsewhere. A large proportion of those with POAG had not been previously diagnosed. One fifth of those with POAG had blindness in one or both eyes from glaucoma. Early detection of glaucoma in this Population will reduce the burden of blindness in India.
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pseudoexfoliation in a Rural Population of southern india the aravind comprehensive eye survey
American Journal of Ophthalmology, 2003Co-Authors: R Krishnadas, Praveen K Nirmalan, R Ramakrishnan, R D Thulasiraj, Joanne Katz, James M Tielsch, David S Friedman, Alan L RobinAbstract:Abstract Objective To determine the prevalence and risk factors for pseudoexfoliation in a Rural Population of southern India. Design A Population-based cross-sectional study of pseudoexfoliation with and without glaucoma in Rural southern India. Participants A total of 5,150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. Methods All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of minimal angle of resolution (logMAR) illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Pseudoexfoliation (PXF) was diagnosed by the presence of typical white deposits on the anterior lens surface; additional sites included the cornea, iris, anterior vitreous face, posterior capsule, and intraocular lens in cataract-operated eyes and changes in the angle determined through gonioscopy, including increased pigmentation, PXF deposition, and PXF material within the angle. Results The prevalence (95% confidence interval) of PXF was 6.0% (5.3, 6.6). The prevalence increased with age ( P P = .01). Of subjects with PXF, 25.7% remained bilaterally blind after best correction; 89.3% of this bilateral blindness was the result of cataracts. The prevalence of glaucoma among subjects with PXF was 7.5%; exfoliation was present in 26.7% of those identified as primary open-angle glaucoma. On multivariate analysis, increasing age and male gender were significantly associated with PXF. Conclusions Pseudoexfoliation appears to be a relatively common disorder in older individuals in southern India. Ophthalmologists in India may wish to focus on the detection of PXF, especially considering the relatively large burden of cataracts in this Population, the risks for operative complications related to PXF, and the fact that PXF may be used as a marker to aid in the detectection of glaucoma.
Catherine A Mccarty - One of the best experts on this subject based on the ideXlab platform.
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prevalence of primary open angle glaucoma in an urban south indian Population and comparison with a Rural Population the chennai glaucoma study
Ophthalmology, 2008Co-Authors: Lingam Vijaya, Ronnie George, Mani Baskaran, H Arvind, Prema Raju, Ve S Ramesh, Govindasamy Kumaramanickavel, Catherine A MccartyAbstract:Objective To estimate the prevalence and risk factors of primary open-angle glaucoma (POAG) in an urban Population and compare the same with that of our published Rural Population data in southern India. Design Population-based cross-sectional study. Participants Four thousand eight hundred subjects 40 years or older were selected using a multistage random cluster sampling procedure in Chennai city. Intervention Three thousand eight hundred fifty (80.2%) subjects underwent a complete ophthalmic examination, including applanation tonometry, gonioscopy, pachymetry, optic disc photography, and automated perimetry. Main Outcome Measures Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology Classification. Results The distribution of intraocular pressure (IOP) and vertical cup-to-disc ratio (VCDR) was obtained from the right eye of the 2532 subjects with normal suprathreshold visual fields. Mean IOP was 16.17±3.74 mmHg (97.5th and 99.5th percentiles, 24 mmHg and 30 mmHg). The mean VCDR was 0.43±0.17 (97.5th and 99.5th percentiles, 0.7 and 0.8). One hundred thirty-five (64 men, 71 women) subjects had POAG (3.51%; 95% confidence interval [CI], 3.04–4.0). Primary open-angle glaucoma subjects (58.4±11.3 years) were older ( P P Conclusions The prevalence of POAG in a ≥40-year-old south Indian urban Population was 3.51%, higher than that of the Rural Population. The prevalence increased with age, and >90% were not aware of the disease.
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prevalence of primary angle closure disease in an urban south indian Population and comparison with a Rural Population the chennai glaucoma study
Ophthalmology, 2008Co-Authors: Lingam Vijaya, Ronnie George, Mani Baskaran, H Arvind, Prema Raju, Ve S Ramesh, Govindasamy Kumaramanickavel, Catherine A MccartyAbstract:Objective To determine the prevalence of primary angle-closure glaucoma (PACG), primary angle closure (PAC), and PAC suspect (PACS) in an urban Population, and to compare prevalence and associated risk factors with a Rural Population. Design Population-based cross-sectional study. Participants Four thousand eight hundred subjects 40 years or older were selected from Chennai city using multistage random cluster sampling. Intervention All subjects had a complete ophthalmic examination that included logarithm of the minimum angle of resolution visual acuity, applanation tonometry, gonioscopy, grading of lens opacities, dilated fundus examination, optic disc photography, and visual fields. Main Outcome Measures Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology classification. Results Three thousand eight hundred fifty (80.2%) responded; 34 subjects (17 female, 17 male) had PACG (0.88%; 95% confidence interval [CI], 0.60–1.16). The mean intraocular pressure (IOP) was 26.0±14.9 mmHg. Five subjects (14.7%) had been previously diagnosed to have glaucoma, 1 of whom had undergone glaucoma surgery and 2 of whom had been diagnosed to have open-angle glaucoma. Two subjects (5.9%) were bilaterally and 3 subjects (8.8%) were unilaterally blind. One hundred six subjects (2.75%; 95% CI, 2.01–3.49) were diagnosed to have PAC (62 female, 44 male). Thirty-nine subjects (36.8%) had presenting IOP > 24 mmHg, 83 (78.3%) had peripheral anterior synechiae, and 16 (15.1%) had both. Two hundred seventy-eight subjects (7.24%; 95% CI, 6.38–8.02) had PACS (183 female, 95 male). Prevalences of PACG and PACS were similar in the urban and Rural Populations. Primary angle closure prevalence was higher in the urban Population ( P Conclusions Prevalences of PACG and PACS were similar in the Rural and urban Populations; PAC was more common in the urban Population. In both groups, the disease was asymptomatic. Poor detection rates were probably due to lack of gonioscopy as a routine part of an eye examination.
David S Friedman - One of the best experts on this subject based on the ideXlab platform.
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glaucoma in a Rural Population of southern india the aravind comprehensive eye survey
Ophthalmology, 2003Co-Authors: R Ramakrishnan, Praveen K Nirmalan, R Krishnadas, R D Thulasiraj, Joanne Katz, James M Tielsch, David S Friedman, Alan L RobinAbstract:Abstract Purpose To determine the prevalence of glaucoma and risk factors for primary open-angle glaucoma in a Rural Population of southern India. Design A Population-based cross-sectional study. Participants A total of 5150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. Methods All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of the minimum angle of resolution illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Main outcome measures Definite primary open-angle glaucoma (POAG) was defined as angles open on gonioscopy and glaucomatous optic disc changes with matching visual field defects, whereas ocular hypertension was defined as intraocular pressure (IOP) greater than 21 mmHg without glaucomatous optic disc damage and visual field defects in the presence of an open angle. Manifest primary angle-closure glaucoma (PACG) was defined as glaucomatous optic disc damage or glaucomatous visual field defects with the anterior chamber angle partly or totally closed, appositional angle closure or synechiae in the angle, and absence of signs of secondary angle closure. Secondary glaucoma was defined as glaucomatous optic nerve damage and/or visual field abnormalities suggestive of glaucoma with ocular disorders that contribute to a secondary elevation in IOP. Results The prevalence (95% confidence interval) of any glaucoma was 2.6% (2.2, 3.0), of POAG it was 1.7% (1.3, 2.1), and if PACG it was 0.5% (0.3, 0.7), and secondary glaucoma excluding pseudoexfoliation was 0.3% (0.2,0.5). On multivariate analysis, increasing age, male gender, myopia greater than 1 diopter, and pseudoexfoliation were significantly associated with POAG. After best correction, 18 persons (20.9%) with POAG were blind in either eye because of glaucoma, including 6 who were bilaterally blind and an additional 12 persons with unilateral blindness because of glaucomatous optic neuropathy in that eye. Of those identified with POAG, 93.0% had not been previously diagnosed with POAG. Conclusions The prevalence of glaucoma in this Population is not lower than that reported for white Populations elsewhere. A large proportion of those with POAG had not been previously diagnosed. One fifth of those with POAG had blindness in one or both eyes from glaucoma. Early detection of glaucoma in this Population will reduce the burden of blindness in India.
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pseudoexfoliation in a Rural Population of southern india the aravind comprehensive eye survey
American Journal of Ophthalmology, 2003Co-Authors: R Krishnadas, Praveen K Nirmalan, R Ramakrishnan, R D Thulasiraj, Joanne Katz, James M Tielsch, David S Friedman, Alan L RobinAbstract:Abstract Objective To determine the prevalence and risk factors for pseudoexfoliation in a Rural Population of southern India. Design A Population-based cross-sectional study of pseudoexfoliation with and without glaucoma in Rural southern India. Participants A total of 5,150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. Methods All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of minimal angle of resolution (logMAR) illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Pseudoexfoliation (PXF) was diagnosed by the presence of typical white deposits on the anterior lens surface; additional sites included the cornea, iris, anterior vitreous face, posterior capsule, and intraocular lens in cataract-operated eyes and changes in the angle determined through gonioscopy, including increased pigmentation, PXF deposition, and PXF material within the angle. Results The prevalence (95% confidence interval) of PXF was 6.0% (5.3, 6.6). The prevalence increased with age ( P P = .01). Of subjects with PXF, 25.7% remained bilaterally blind after best correction; 89.3% of this bilateral blindness was the result of cataracts. The prevalence of glaucoma among subjects with PXF was 7.5%; exfoliation was present in 26.7% of those identified as primary open-angle glaucoma. On multivariate analysis, increasing age and male gender were significantly associated with PXF. Conclusions Pseudoexfoliation appears to be a relatively common disorder in older individuals in southern India. Ophthalmologists in India may wish to focus on the detection of PXF, especially considering the relatively large burden of cataracts in this Population, the risks for operative complications related to PXF, and the fact that PXF may be used as a marker to aid in the detectection of glaucoma.
Praveen K Nirmalan - One of the best experts on this subject based on the ideXlab platform.
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ocular trauma in a Rural Population of southern india the andhra pradesh eye disease study
Ophthalmology, 2006Co-Authors: Sannapaneni Krishnaiah, Praveen K Nirmalan, B R Shamanna, Srinivas Marmamula, Gullapalli N Rao, Ravi ThomasAbstract:Objective To determine the prevalence of ocular trauma and proportion of blindness and visual impairment due to ocular trauma in a Rural Population of southern India. Design Population-based cross-sectional epidemiological study. Participants A total of 7771 subjects of all ages, representative of the Rural Population of Andhra Pradesh. Methods The subjects underwent a detailed interview and comprehensive ocular evaluation as part of the Population-based Andhra Pradesh Eye Disease Study. Main Outcome An eye was considered to be blind due to trauma if best-corrected distance visual acuity was worse than 6/60 and the cause was attributed to ocular trauma. Results A total of 824 (10.6%) subjects gave a history of ocular trauma in either eye, including 76 (1.0%) persons reporting trauma in both eyes. The overall age- and gender-adjusted prevalence of history of eye injury in this Rural Population was 7.5% (95% confidence interval [CI], 7.0%–8.1%). Men were more likely to have an eye injury than women (odds ratio [OR], 2.1 [95% CI, 1.8–2.5]). After adjusting for gender and other demographic factors, ocular trauma was significantly more frequent among laborers (OR, 1.5 [95% CI, 1.2–1.7]) when compared with other occupational groups. After adjusting for gender, injury with vegetable matter such as a thorn, branch of a tree, plant secretion, etc. (n = 373 [45.3%]) was the major cause of trauma reported in this Population. The majority of the eye injuries occurred at the workplace (n = 461 [55.9%]), followed by home (n = 179 [21.7%]). The majority of those affected (n = 806 [97.8%]) did not wear any eye protection at the time of trauma. A significant proportion (n = 307 [43.1%]) of subjects who sought treatment for an eye injury went to an ophthalmologist. Trauma was responsible for unilateral blindness in 39 subjects, an age- and gender-adjusted prevalence of 0.6% (95% CI, 0.4%–0.8%). Conclusions Most ocular injuries in this Rural Population occurred at the workplace, suggesting the need to explore workplace strategies to minimize ocular trauma as a priority. Eye care programs targeting high-risk ocular trauma groups may need to consider ocular trauma as a priority in eye health awareness strategies to reduce blindness due to trauma.
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glaucoma in a Rural Population of southern india the aravind comprehensive eye survey
Ophthalmology, 2003Co-Authors: R Ramakrishnan, Praveen K Nirmalan, R Krishnadas, R D Thulasiraj, Joanne Katz, James M Tielsch, David S Friedman, Alan L RobinAbstract:Abstract Purpose To determine the prevalence of glaucoma and risk factors for primary open-angle glaucoma in a Rural Population of southern India. Design A Population-based cross-sectional study. Participants A total of 5150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. Methods All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of the minimum angle of resolution illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Main outcome measures Definite primary open-angle glaucoma (POAG) was defined as angles open on gonioscopy and glaucomatous optic disc changes with matching visual field defects, whereas ocular hypertension was defined as intraocular pressure (IOP) greater than 21 mmHg without glaucomatous optic disc damage and visual field defects in the presence of an open angle. Manifest primary angle-closure glaucoma (PACG) was defined as glaucomatous optic disc damage or glaucomatous visual field defects with the anterior chamber angle partly or totally closed, appositional angle closure or synechiae in the angle, and absence of signs of secondary angle closure. Secondary glaucoma was defined as glaucomatous optic nerve damage and/or visual field abnormalities suggestive of glaucoma with ocular disorders that contribute to a secondary elevation in IOP. Results The prevalence (95% confidence interval) of any glaucoma was 2.6% (2.2, 3.0), of POAG it was 1.7% (1.3, 2.1), and if PACG it was 0.5% (0.3, 0.7), and secondary glaucoma excluding pseudoexfoliation was 0.3% (0.2,0.5). On multivariate analysis, increasing age, male gender, myopia greater than 1 diopter, and pseudoexfoliation were significantly associated with POAG. After best correction, 18 persons (20.9%) with POAG were blind in either eye because of glaucoma, including 6 who were bilaterally blind and an additional 12 persons with unilateral blindness because of glaucomatous optic neuropathy in that eye. Of those identified with POAG, 93.0% had not been previously diagnosed with POAG. Conclusions The prevalence of glaucoma in this Population is not lower than that reported for white Populations elsewhere. A large proportion of those with POAG had not been previously diagnosed. One fifth of those with POAG had blindness in one or both eyes from glaucoma. Early detection of glaucoma in this Population will reduce the burden of blindness in India.
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pseudoexfoliation in a Rural Population of southern india the aravind comprehensive eye survey
American Journal of Ophthalmology, 2003Co-Authors: R Krishnadas, Praveen K Nirmalan, R Ramakrishnan, R D Thulasiraj, Joanne Katz, James M Tielsch, David S Friedman, Alan L RobinAbstract:Abstract Objective To determine the prevalence and risk factors for pseudoexfoliation in a Rural Population of southern India. Design A Population-based cross-sectional study of pseudoexfoliation with and without glaucoma in Rural southern India. Participants A total of 5,150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. Methods All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of minimal angle of resolution (logMAR) illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. Pseudoexfoliation (PXF) was diagnosed by the presence of typical white deposits on the anterior lens surface; additional sites included the cornea, iris, anterior vitreous face, posterior capsule, and intraocular lens in cataract-operated eyes and changes in the angle determined through gonioscopy, including increased pigmentation, PXF deposition, and PXF material within the angle. Results The prevalence (95% confidence interval) of PXF was 6.0% (5.3, 6.6). The prevalence increased with age ( P P = .01). Of subjects with PXF, 25.7% remained bilaterally blind after best correction; 89.3% of this bilateral blindness was the result of cataracts. The prevalence of glaucoma among subjects with PXF was 7.5%; exfoliation was present in 26.7% of those identified as primary open-angle glaucoma. On multivariate analysis, increasing age and male gender were significantly associated with PXF. Conclusions Pseudoexfoliation appears to be a relatively common disorder in older individuals in southern India. Ophthalmologists in India may wish to focus on the detection of PXF, especially considering the relatively large burden of cataracts in this Population, the risks for operative complications related to PXF, and the fact that PXF may be used as a marker to aid in the detectection of glaucoma.
Lingam Vijaya - One of the best experts on this subject based on the ideXlab platform.
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prevalence of primary open angle glaucoma in an urban south indian Population and comparison with a Rural Population the chennai glaucoma study
Ophthalmology, 2008Co-Authors: Lingam Vijaya, Ronnie George, Mani Baskaran, H Arvind, Prema Raju, Ve S Ramesh, Govindasamy Kumaramanickavel, Catherine A MccartyAbstract:Objective To estimate the prevalence and risk factors of primary open-angle glaucoma (POAG) in an urban Population and compare the same with that of our published Rural Population data in southern India. Design Population-based cross-sectional study. Participants Four thousand eight hundred subjects 40 years or older were selected using a multistage random cluster sampling procedure in Chennai city. Intervention Three thousand eight hundred fifty (80.2%) subjects underwent a complete ophthalmic examination, including applanation tonometry, gonioscopy, pachymetry, optic disc photography, and automated perimetry. Main Outcome Measures Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology Classification. Results The distribution of intraocular pressure (IOP) and vertical cup-to-disc ratio (VCDR) was obtained from the right eye of the 2532 subjects with normal suprathreshold visual fields. Mean IOP was 16.17±3.74 mmHg (97.5th and 99.5th percentiles, 24 mmHg and 30 mmHg). The mean VCDR was 0.43±0.17 (97.5th and 99.5th percentiles, 0.7 and 0.8). One hundred thirty-five (64 men, 71 women) subjects had POAG (3.51%; 95% confidence interval [CI], 3.04–4.0). Primary open-angle glaucoma subjects (58.4±11.3 years) were older ( P P Conclusions The prevalence of POAG in a ≥40-year-old south Indian urban Population was 3.51%, higher than that of the Rural Population. The prevalence increased with age, and >90% were not aware of the disease.
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prevalence of primary angle closure disease in an urban south indian Population and comparison with a Rural Population the chennai glaucoma study
Ophthalmology, 2008Co-Authors: Lingam Vijaya, Ronnie George, Mani Baskaran, H Arvind, Prema Raju, Ve S Ramesh, Govindasamy Kumaramanickavel, Catherine A MccartyAbstract:Objective To determine the prevalence of primary angle-closure glaucoma (PACG), primary angle closure (PAC), and PAC suspect (PACS) in an urban Population, and to compare prevalence and associated risk factors with a Rural Population. Design Population-based cross-sectional study. Participants Four thousand eight hundred subjects 40 years or older were selected from Chennai city using multistage random cluster sampling. Intervention All subjects had a complete ophthalmic examination that included logarithm of the minimum angle of resolution visual acuity, applanation tonometry, gonioscopy, grading of lens opacities, dilated fundus examination, optic disc photography, and visual fields. Main Outcome Measures Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology classification. Results Three thousand eight hundred fifty (80.2%) responded; 34 subjects (17 female, 17 male) had PACG (0.88%; 95% confidence interval [CI], 0.60–1.16). The mean intraocular pressure (IOP) was 26.0±14.9 mmHg. Five subjects (14.7%) had been previously diagnosed to have glaucoma, 1 of whom had undergone glaucoma surgery and 2 of whom had been diagnosed to have open-angle glaucoma. Two subjects (5.9%) were bilaterally and 3 subjects (8.8%) were unilaterally blind. One hundred six subjects (2.75%; 95% CI, 2.01–3.49) were diagnosed to have PAC (62 female, 44 male). Thirty-nine subjects (36.8%) had presenting IOP > 24 mmHg, 83 (78.3%) had peripheral anterior synechiae, and 16 (15.1%) had both. Two hundred seventy-eight subjects (7.24%; 95% CI, 6.38–8.02) had PACS (183 female, 95 male). Prevalences of PACG and PACS were similar in the urban and Rural Populations. Primary angle closure prevalence was higher in the urban Population ( P Conclusions Prevalences of PACG and PACS were similar in the Rural and urban Populations; PAC was more common in the urban Population. In both groups, the disease was asymptomatic. Poor detection rates were probably due to lack of gonioscopy as a routine part of an eye examination.