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Incidence of primary open angle glaucoma in the Andhra Pradesh Eye Disease Study (APEDS)

Eye (2023)Cite this article

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Abstract

Background

To report 15-year incidence rate of primary open angle glaucoma (POAG) in the Andhra Pradesh Eye Disease Study (APEDS).

Methods

A population-based longitudinal study was carried out at three rural study sites. Phakic participants aged ≥40 years who participated at baseline (APEDS I) and the mean 15-year follow-up visit (APEDS III) were included. A comprehensive ophthalmic examination was performed on all participants. Mean intraocular pressure (IOP) was average of IOPs of right and left eyes. The definition of glaucoma was based on the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification. The main outcome measure was incidence of POAG during the follow-up period in participants without glaucoma or suspicion of glaucoma at baseline.

Results

Data from the available and eligible participants from the original cohort (1241/2790; 44.4%) were analysed. The mean age (standard deviation) of participants at baseline was 50.2 (8.1) years; 580 (46.7%) were men. Thirty-six participants developed POAG [bilateral in 17 (47.2%)] over 15 years. The incidence rate of POAG per 100-person years (95% confidence interval) was 2.83 (2.6, 3.08). Compared to baseline, the reduction in mean IOP [median (range) mm Hg] was −0.75 (−7.5, 9) in participants with incident POAG and −2.5 (−14.5, 14.5) in those without. The inter-visit difference in mean IOP was a significant risk factor on logistic regression analysis.

Conclusion

We report the long-term incidence of POAG in rural India. A longitudinal change in IOP, specifically a less pronounced reduction in IOP with increasing age, was a novel risk factor.

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Fig. 1: Flow of study participants.

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Data availability

The datasets generated during and/or analysed 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, Telangana State, 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, Telangana, 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. School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA

    Rohit C. Khanna

  6. Department of Biotechnology/ Wellcome Trust India Alliance, L V Prasad Eye Institute, Banjara Hills, 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 & Tropical Medicine, London, UK

    Gudlavalleti V. S. Murthy & Clare Gilbert

Authors
  1. Nikhil S. Choudhari
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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. Incidence of primary open angle glaucoma in the Andhra Pradesh Eye Disease Study (APEDS). Eye (2023). https://doi.org/10.1038/s41433-023-02799-z

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