Overdiagnosis of open-angle glaucoma in the general population

the Thessaloniki Eye Study

Panayiota Founti, Anne L. Coleman, M. Roy Wilson, Fei Yu, Eleftherios Anastasopoulos, Alon Harris, Theofanis Pappas, Archimidis Koskosas, Vassilis Kilintzis, Angeliki Salonikiou, Anastasia Raptou, Fotis Topouzis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To assess the overdiagnosis of open-angle glaucoma (OAG) and to investigate associated factors. Methods: This was a cross-sectional, population-based study of an urban Caucasian population in northern Greece. Randomly selected subjects ≥60 years (n = 2554) participated in the Thessaloniki Eye Study. The definition of OAG required the presence of structural and functional damage, irrespective of intraocular pressure (IOP). Non-OAG subjects were classified as overdiagnosed with OAG if they had reported at least one of the following (self-reported glaucoma): (i) prior diagnosis of glaucoma, (ii) prior laser for glaucoma, (iii) prior glaucoma surgery. Factors associated with the overdiagnosis of OAG were investigated using a logistic regression model. Results: Of 57 (2.2%) subjects with self-reported glaucoma, 34 (60%) were overdiagnosed with OAG, corresponding to a prevalence of 1.3% (34/2554). In a logistic regression model among non-OAG subjects, worse visual acuity (VA) (20/200 or worse versus 20/25 or better; odds ratio (OR) = 4.30, 95% Confidence Intervals (CI), 1.13–16.35), family history of glaucoma (OR = 8.69, 95% CI, 2.83–26.67) and history of cataract surgery (OR = 11.50, 95% CI, 3.85–34.36) were statistically significantly associated with the overdiagnosis of OAG. Age, sex, higher IOP, higher vertical cup-to-disc ratio and pseudoexfoliation were not statistically significant. Conclusion: The overdiagnosis of OAG was substantial in this elderly, Caucasian population. The overdiagnosis of glaucoma has not been previously addressed in population-based studies and needs to be further explored.

Original languageEnglish (US)
JournalActa Ophthalmologica
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Open Angle Glaucoma
Glaucoma
Population
Logistic Models
Odds Ratio
Confidence Intervals
Intraocular Pressure
Medical Overuse
Urban Population
Greece
Cataract
Visual Acuity
Lasers

Keywords

  • epidemiology
  • open-angle glaucoma
  • overdiagnosis
  • population-based study

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Founti, P., Coleman, A. L., Wilson, M. R., Yu, F., Anastasopoulos, E., Harris, A., ... Topouzis, F. (Accepted/In press). Overdiagnosis of open-angle glaucoma in the general population: the Thessaloniki Eye Study. Acta Ophthalmologica. https://doi.org/10.1111/aos.13758

Overdiagnosis of open-angle glaucoma in the general population : the Thessaloniki Eye Study. / Founti, Panayiota; Coleman, Anne L.; Wilson, M. Roy; Yu, Fei; Anastasopoulos, Eleftherios; Harris, Alon; Pappas, Theofanis; Koskosas, Archimidis; Kilintzis, Vassilis; Salonikiou, Angeliki; Raptou, Anastasia; Topouzis, Fotis.

In: Acta Ophthalmologica, 01.01.2018.

Research output: Contribution to journalArticle

Founti, P, Coleman, AL, Wilson, MR, Yu, F, Anastasopoulos, E, Harris, A, Pappas, T, Koskosas, A, Kilintzis, V, Salonikiou, A, Raptou, A & Topouzis, F 2018, 'Overdiagnosis of open-angle glaucoma in the general population: the Thessaloniki Eye Study', Acta Ophthalmologica. https://doi.org/10.1111/aos.13758
Founti, Panayiota ; Coleman, Anne L. ; Wilson, M. Roy ; Yu, Fei ; Anastasopoulos, Eleftherios ; Harris, Alon ; Pappas, Theofanis ; Koskosas, Archimidis ; Kilintzis, Vassilis ; Salonikiou, Angeliki ; Raptou, Anastasia ; Topouzis, Fotis. / Overdiagnosis of open-angle glaucoma in the general population : the Thessaloniki Eye Study. In: Acta Ophthalmologica. 2018.
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abstract = "Purpose: To assess the overdiagnosis of open-angle glaucoma (OAG) and to investigate associated factors. Methods: This was a cross-sectional, population-based study of an urban Caucasian population in northern Greece. Randomly selected subjects ≥60 years (n = 2554) participated in the Thessaloniki Eye Study. The definition of OAG required the presence of structural and functional damage, irrespective of intraocular pressure (IOP). Non-OAG subjects were classified as overdiagnosed with OAG if they had reported at least one of the following (self-reported glaucoma): (i) prior diagnosis of glaucoma, (ii) prior laser for glaucoma, (iii) prior glaucoma surgery. Factors associated with the overdiagnosis of OAG were investigated using a logistic regression model. Results: Of 57 (2.2{\%}) subjects with self-reported glaucoma, 34 (60{\%}) were overdiagnosed with OAG, corresponding to a prevalence of 1.3{\%} (34/2554). In a logistic regression model among non-OAG subjects, worse visual acuity (VA) (20/200 or worse versus 20/25 or better; odds ratio (OR) = 4.30, 95{\%} Confidence Intervals (CI), 1.13–16.35), family history of glaucoma (OR = 8.69, 95{\%} CI, 2.83–26.67) and history of cataract surgery (OR = 11.50, 95{\%} CI, 3.85–34.36) were statistically significantly associated with the overdiagnosis of OAG. Age, sex, higher IOP, higher vertical cup-to-disc ratio and pseudoexfoliation were not statistically significant. Conclusion: The overdiagnosis of OAG was substantial in this elderly, Caucasian population. The overdiagnosis of glaucoma has not been previously addressed in population-based studies and needs to be further explored.",
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AU - Coleman, Anne L.

AU - Wilson, M. Roy

AU - Yu, Fei

AU - Anastasopoulos, Eleftherios

AU - Harris, Alon

AU - Pappas, Theofanis

AU - Koskosas, Archimidis

AU - Kilintzis, Vassilis

AU - Salonikiou, Angeliki

AU - Raptou, Anastasia

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N2 - Purpose: To assess the overdiagnosis of open-angle glaucoma (OAG) and to investigate associated factors. Methods: This was a cross-sectional, population-based study of an urban Caucasian population in northern Greece. Randomly selected subjects ≥60 years (n = 2554) participated in the Thessaloniki Eye Study. The definition of OAG required the presence of structural and functional damage, irrespective of intraocular pressure (IOP). Non-OAG subjects were classified as overdiagnosed with OAG if they had reported at least one of the following (self-reported glaucoma): (i) prior diagnosis of glaucoma, (ii) prior laser for glaucoma, (iii) prior glaucoma surgery. Factors associated with the overdiagnosis of OAG were investigated using a logistic regression model. Results: Of 57 (2.2%) subjects with self-reported glaucoma, 34 (60%) were overdiagnosed with OAG, corresponding to a prevalence of 1.3% (34/2554). In a logistic regression model among non-OAG subjects, worse visual acuity (VA) (20/200 or worse versus 20/25 or better; odds ratio (OR) = 4.30, 95% Confidence Intervals (CI), 1.13–16.35), family history of glaucoma (OR = 8.69, 95% CI, 2.83–26.67) and history of cataract surgery (OR = 11.50, 95% CI, 3.85–34.36) were statistically significantly associated with the overdiagnosis of OAG. Age, sex, higher IOP, higher vertical cup-to-disc ratio and pseudoexfoliation were not statistically significant. Conclusion: The overdiagnosis of OAG was substantial in this elderly, Caucasian population. The overdiagnosis of glaucoma has not been previously addressed in population-based studies and needs to be further explored.

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KW - overdiagnosis

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