Outpatient Distribution for Glaucoma Evaluation

Ka Hee Park; So Yeon Lee; Young Jae Hong

doi:10.7469/JKOS.2015.56.03.388

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Park, Lee, and Hong: Outpatient Distribution for Glaucoma Evaluation

Original Article

J Korean Ophthalmol Soc 2015;56(3):388-395.

Published online: 7 September 2015

DOI: https://doi.org/10.7469/JKOS.2015.56.03.388

Outpatient Distribution for Glaucoma Evaluation

Ka Hee Park, MD, So Yeon Lee, MD, Young Jae Hong, MD, PhD

Nune Eye Hospital, Seoul, Korea

￭ Address reprint requests to Young Jae Hong, MD, PhD Nune Eye Hospital, #404 Seolleung-ro, Gangnam-gu, Seoul 135-841, Korea Tel: 82-2-2086-7789, Fax: 82-2-2086-7710 E-mail: youngjhong@gmail.com

Received 5 July 201419 September 2014 Accepted 17 February 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose:

To analyze the reasons for glaucoma evaluation and distribution of new patients visiting the glaucoma department.

Methods:

In a retrospective study, 330 new patients underwent ocular examination using Goldmann applanation tonometry, go-nioscopy, optic disc analysis, optical coherence tomography, and Humphrey perimeter under suspicion of glaucoma for the first time in the Glaucoma Department from January 2013 to December 2013. We analyzed the reasons and their diagnostic outcomes.

Results:

The reasons for glaucoma evaluation were health screening (103 patients, 32.49%), other symptoms (102 patients, 31.55%), known glaucoma (56 patients, 17.67%), pre-refractive surgery evaluation (31 patients, 9.78%), family history (19 patients, 5.99%), and high myopia (6 patients, 1.89%). The diagnostic outcomes were as follows: glaucoma (139 patients, 43.85%), glaucoma suspect (60 patients, 18.93%), ocular hypertension (9 patients, 2.84%), neither glaucoma nor ocular hypertension (79 patients, 24.92%), normal (30 patients, 9.46%). The percentages of confirmed glaucoma according to the reasons for glaucoma evaluation were as follows: health screening, 26.21%; other symptoms, 40.20%; known glaucoma, 85.71%; pre-re-fractive surgery evaluation, 58.06%; family history, 15.79% and high myopia, 33.33%.

Conclusions:

The reasons for glaucoma evaluation were diverse. Glaucoma was confirmed in 43.85% of the patients and the predicted value of positive test for glaucoma including glaucoma suspect and ocular hypertension was 65.62%.

Keywords: Distribution, Glaucoma, New patients, Reasons

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Figure 1.

Motives for visiting the department of glaucoma of (A) first visit patients and referrals, (B) total patients.

Figure 2.

Diagnostic outcomes of patients according to the motives for visiting the department of glaucoma. OHT = ocular hypertension.

Figure 3.

Comparison of intraocular pressure and refractive error among diagnostic outcomes. p < 0.05 by ANOVA and Scheffe test was considered to be significant. NTG = normal tension glaucoma; POAG = primary open angle glaucoma; PACG = primary angle closure glaucoma; SG = secondary glaucoma.

Table 1.

Patients’ characteristics

Chararcteristics	Total (n = 317)
Age (years)	48.99 ± 15.89
≤30 (n, %)	37 (11.7)
31-40	69 (21.8)
41-50	66 (20.8)
51-60	69 (21.8)
61-70	45 (14.2)
>70	31 (9.8)
Sex (M:F) (n, %)	158:159 (49.8:50.2)
Past medical history (n, %)
Hypertesion	44 (13.9)
Diabetes mellitus	27 (8.5)
IOP at first visit (mm Hg)	16.93 ± 4.86
Refractive error (diopter)	-2.55 ± 3.50
Family history (n, %)	33 (10.4)
Glaucoma medication (n, %)	77 (24.3)

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure.

Table 2.

Distribution of patients

Type	No. of patients (n, %)
Glaucoma	139 (43.9)
NTG	79
POAG	35
PACG	12
Secondary glaucoma	13
Uveitic glaucoma	7
Neovascular glaucoma	3
Traumatic glaucoma	2
Lens induced glaucoma	1
Glaucoma suspect	60 (18.9)
Ocular hypertension	9 (2.8)
Neither glaucoma nor OHT	79 (24.9)
Normal	30 (9.5)
Total	317

NTG = normal tension glaucoma; POAG = primary open angle glaucoma; PACG = primary angle closure glaucoma; OHT = ocular hypertension; No = number.

Table 3.

The characteristics of patients divided into diagnostic outcomes

	Glaucoma (n = 139)	Glaucoma suspect (n = 60)	OHT (n = 9)	Neither glaucoma nor OHT (n = 79)	Normal (n = 30)	p-value
Age (years)	53.97 ± 15.36	48.62 ± 15.14	38.00 ± 17.07	43.04 ± 13.32	45.63 ± 18.08	0.000^*‡
≤30 (n)	7	9	3	11	7
31-40	24	10	2	27	5
41-50	31	12	1	18	4
51-60	34	15	2	13	7
61-70	21	11	1	9	4
>70	19	3	0	1	3
Sex (M:F) (n, %)	76:63	30:30	4:5	38:41	9:21	0.184^†
	(54.7:45.3)	(50.0:50.0)	(44.4:55.6)	(48.1:51.9)	(30.0:70.0)
HTN (n, %)	30 (21.6)	6 (10.0)	1 (11.1)	4 (5.1)	3 (10.0)	0.010^†‡
DM (n, %)	17 (12.2)	6 (10.0)	0 (0.0)	1 (1.3)	3 (10.0)	0.064^†
IOP (mm Hg)	17.21 ± 5.78	17.95 ± 5.36	21.94 ± 15.14	15.57 ± 2.66	15.52 ± 2.68	0.000^*‡
Ref. error (SE, diopter)	-2.48 ± 3.71	-2.64 ± 3.42	-2.86 ± 4.16	-2.78 ± 3.28	-2.22 ± 3.05	0.221^*
Family Hx (n, %)	6 (4.3)	8 (13.3)	0 (0.0)	11 (13.9)	9 (30.0)	0.001^†‡
C/D ratio	0.71 ± 0.17	0.62 ± 0.13	0.34 ± 0.11	0.58 ± 0.12	0.34 ± 0.08	0.000^*‡
CCT (μ m)	556.97 ± 109.68	561.71 ± 35.29	591.43 ± 17.43	552.58 ± 36.54	566.05 ± 34.21	0.420^*
MD (dB)	-8.85 ± 8.37	-1.29 ± 1.78	-1.60 ± 1.01	-1.20 ± 1.47	-1.49 ± 2.18	0.000^*‡
CPSD (dB)	6.50 ± 4.67	3.15 ± 13.13	1.71 ± 0.57	1.80 ± 1.06	1.98 ± 1.25	0.000^*‡

Values are presented as mean ± SD unless otherwise indicated.

OHT = ocular hypertension; M = male; F = female; HTN = hypertension; DM = diabetes mellitus; IOP = intraocular pressure; Ref = refractive; SE = spherical equivalent; Hx = history; C/D = cup to disc; CCT = central corneal thickness; MD = mean deviation; CPSD = corrected pattern standard deviation.

^* ANOVA;

^† Chi-square test;

^‡ p < 0.05 was considered to be significant.

Table 4.

The characteristics of glaucoma patients

	NTG (n = 79)	POAG (n = 35)	PACG (n = 12)	SG (n = 13)	p-value
Age (years)	52.15 ± 14.60	54.97 ± 16.95	64.17 ± 13.33	52.92 ± 15.99	0.087^*
≤30 (n)	3	2	0	2
31-40	16	6	1	1
41-50	20	7	1	3
51-60	21	8	3	3
61-70	9	8	3	3
>70	10	4	4	1
Sex (M:F) (n, %)	46:33	19:16	3:9	8:5	0.178^†
	(58.2:41.8)	(54.3:45.7)	(25.0:75.0)	(61.5:38.5)
HTN (n, %)	14 (17.7)	7 (20.0)	5 (41.7)	4 (30.8)	0.235^†
DM (n, %)	8 (11.4)	7 (8.6)	2 (16.7)	4 (30.8)	0.162^†
IOP (mm Hg)	15.46 ± 3.21	20.02 ± 5.76	19.75 ± 9.73	21.15 ± 10.97	0.000^*‡
Ref. error (SE, diopter)	-2.90 ± 3.37	-1.83 ± 2.93	0.16 ± 1.80	-1.75 ± 2.54	0.018^*‡
Family history (n, %)	4 (5.1)	2 (5.7)	0 (0.0)	0 (0.0)	0.706^†

Values are presented as mean ± SD unless otherwise indicated.

NTG = normal tension glaucoma; POAG = primary open angle glaucoma; PACG = primary angle closure glaucoma; SG = Secondary glaucoma; M = male; F = female; HTN = hypertension; DM = diabetes mellitus; IOP = intraocular pressure; Ref = refractive; SE = spherical equivalent.

^* ANOVA;

^† Chi-square test;

^‡ p < 0.05 was considered to be significant.

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