Clinical profile of newly diagnosed glaucoma patients in Brazil

Purpose

Describe clinical characteristics of newly diagnosed glaucoma patients and identify risk factors associated with advanced stage of glaucoma.

Design

Retrospective multicenter study.

Methods

We included patients over 18 years old with newly diagnosed glaucoma in 6 medical centers from different regions of Brazil. We applied logistic regression to assess odds ratios (OR) to identify risk factors for the patient to present advanced stage of glaucoma at diagnosis.

Results

We included a total of 523 glaucoma patients. Mean age at the time of diagnosis was 64.5 years (± 12.4 years), with the majority being Caucasian (82.94 %). We found that 20 % of patients had advanced disease at diagnosis, with a low vision prevalence of 4.21 %. In the multivariable logistic regression, we found that older patients [odds ratio (OR) = 1.04 per year; 95 % confidence interval (CI):1.02–1.06; P < 0.001) and patients with higher intraocular pressure (IOP) at baseline (OR = 1.08 per mmHg; 95 % CI: 1.04–1.12; P < 0.001) were at higher risk to present advanced disease at diagnosis. In contrast, normal tension glaucoma patients (OR = 0.13; 95 % CI: 0.00–00.20; P = 0.024) had lower risk to present advanced disease at diagnosis. From the total of 523 patients, 366 (70.2 %) were diagnosed with primary open angle glaucoma (POAG). Within this subgroup of POAG patients, we found that older patients (OR = 1.04 per year; 95 % CI:1.01–1.06; P = 0.001), patients with higher IOP at baseline (OR = 1.09 per mmHg; 95 % CI: 1.04–1.15; P < 0.001) and patients with high myopia (spherical equivalent < -6 diopters, if phakic; or axial length > 26.5 mm, if pseudophakic) (OR = 3.39; 95 % CI: 1.35–8.42; P = 0.009) were at higher risk to present advanced disease at diagnosis.

Conclusions

We found that 20 % of patients had advanced disease at diagnosis, with a low vision prevalence of 4.21 %. We have showed that patients with older age and high IOP at baseline were at higher risk to present advance glaucoma at diagnosis. Within the subgroup of POAG, we found that patients with high IOP at baseline, older age, and high myopia were at higher risk of presenting advanced glaucoma at diagnosis, highlighting the importance of monitoring patients with these clinical characteristics.