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Regional variation in the incidence of pseudo-exfoliation in the Andhra Pradesh Eye Disease Study (APEDS)

Eye volume 37, pages 1704–1710 (2023)Cite this article

Subjects

Abstract

Background

To report the 15-year incidence rate of pseudo-exfoliation (PXF),  PXF glaucoma and regional variation among rural participants in the Andhra Pradesh Eye Disease Study (APEDS) III.

Methods

This population-based longitudinal study was carried out at three rural study sites. Individuals of all ages who participated at baseline with a mean 15-year follow-up visit were included. Detailed Comprehensive ophthalmic examination was performed on all participants. The main outcome measure was development of PXF during the follow-up period in participants who were phakic in one or both eyes without PXF at baseline.

Results

Among 5395 participants, 5108 (94.6%) met the inclusion criteria. There were 93 (1.82%; 95% confidence interval (CI), 1.47–2.22) cases of incident PXF. Their median baseline age (1st, 3rd quartiles) was 51 (44, 59) years and the male: female ratio was 1.3:1. There was no case of incident PXF in participants aged <30 years at baseline. The incidence rate per 100 person years (95% CI) among all ages and those aged ≥30 years at baseline was 1.73 (1.64–1.82) and 3.73 (3.53–3.93), respectively. PXF material was located on iris as well as anterior surface of lens and it was often bilateral. Participants living in two study sites and increasing age were associated with the incidence of PXF. The 15-year incidence of PXF glaucoma (95% CI) in participants ≥30 years of age at baseline was 0.33% (0.14–0.66).

Conclusion

There is significant regional variation in incidence of PXF in south India which warrants further investigation.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Hyderabad Eye Research Foundation, India, Lions Clubs International Foundation, SightFirst Research grant, USA, and Department of Biotechnology, Centre of Excellence (CoE) grant, India.

Author information

Authors and Affiliations

  1. VST Glaucoma Centre, Dr. Kallam Anji Reddy Campus, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India

    Nikhil S. Choudhari

  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, Hyderabad, Telangana, India

    Nikhil S. Choudhari, Rohit C. Khanna, Srinivas Marmamula, Asha Latha Mettla, Pyda Giridhar, Seema Banerjee, Konegari Shekhar, Gullapalli N. Rao, Maneck Nicholson, J. V. Raghava, T Sahitya & E. Y. Lavanya

  3. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India

    Rohit C. Khanna, Srinivas Marmamula, Asha Latha Mettla, Pyda Giridhar, Seema Banerjee, Konegari Shekhar, Subhabrata Chakrabarti, Gullapalli N. Rao, Ritu Dixit, Goutham Pyatla, Alice Arati Anthony, Syed Hameed, Samir Bera, Sneha Kumari & Inderjeet Kaur

  4. School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia

    Rohit C. Khanna & Hira B. Pant

  5. University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA

    Rohit C. Khanna

  6. Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, India

    Srinivas Marmamula

  7. Indian Institute of Public Health, Madhapur, Hyderabad, India

    Gudlavalleti V. S. Murthy

  8. International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK

    Gudlavalleti V. S. Murthy & Clare Gilbert

Authors
  1. Nikhil S. Choudhari
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  2. Rohit C. Khanna
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  3. Srinivas Marmamula
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  4. Asha Latha Mettla
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  5. Pyda Giridhar
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  6. Seema Banerjee
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  7. Konegari Shekhar
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  8. Subhabrata Chakrabarti
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  9. Gudlavalleti V. S. Murthy
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  10. Clare Gilbert
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  11. Gullapalli N. Rao
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Consortia

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

Contributions

NSC was responsible for data analysis, drafted the manuscript, approved the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. RCK conceived and designed the work that led to the submission, acquired data, and played an important role in interpreting the results, revised the manuscript, approved the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. CG played an important role in interpreting the results, revised the manuscript, approved the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All the remaining authors acquired data, played a role in interpreting the results, revised the manuscript, approved the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Rohit C. Khanna.

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Choudhari, N.S., Khanna, R.C., Marmamula, S. et al. Regional variation in the incidence of pseudo-exfoliation in the Andhra Pradesh Eye Disease Study (APEDS). Eye 37, 1704–1710 (2023). https://doi.org/10.1038/s41433-022-02226-9

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  • DOI: https://doi.org/10.1038/s41433-022-02226-9

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