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Ophthalmology. 2014 Jan;121(1):134-141. doi: 10.1016/j.ophtha.2013.09.003. Epub 2013 Oct 25.

Long-term trends in glaucoma-related blindness in Olmsted County, Minnesota.

Author information

1
Department of Ophthalmology, Rochester, Minnesota.
2
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
3
Department of Ophthalmology, Rochester, Minnesota. Electronic address: sit.arthur@mayo.edu.

Abstract

OBJECTIVE:

To determine the longitudinal trends in the probability of blindness due to open-angle glaucoma (OAG) in Olmsted County, Minnesota, from 1965 to 2009.

DESIGN:

Retrospective, population-based cohort study.

PARTICIPANTS:

All residents of Olmsted County, Minnesota (aged ≥ 40 years) who were diagnosed with OAG between January 1, 1965, and December 31, 2000.

METHODS:

All available medical records of every incident case of OAG were reviewed until December 31, 2009, to identify progression to blindness, defined as visual acuity ≤ 20/200 or visual field constriction to ≤ 20°. Kaplan-Meier analysis was used to estimate the cumulative probability of glaucoma-related blindness. Population incidence of blindness within 10 years of diagnosis was calculated using US Census data. Rates for subjects diagnosed in the period 1965-1980 were compared with rates for subjects diagnosed in the period 1981-2000 using log-rank tests and Poisson regression models.

MAIN OUTCOME MEASURES:

Cumulative probability of OAG-related blindness and population incidence of blindness within 10 years of diagnosis.

RESULTS:

Probability of glaucoma-related blindness in at least 1 eye at 20 years decreased from 25.8% (95% confidence interval [CI], 18.5-32.5) for subjects diagnosed in 1965-1980 to 13.5% (95% CI, 8.8-17.9) for subjects diagnosed in 1981-2000 (P = 0.01). The population incidence of blindness within 10 years of the diagnosis decreased from 8.7 per 100,000 (95% CI, 5.9-11.5) for subjects diagnosed in 1965-1980 to 5.5 per 100,000 (95% CI, 3.9-7.2) for subjects diagnosed in 1981-2000 (P = 0.02). Higher age at diagnosis was associated with increased risk of progression to blindness (P < 0.001).

CONCLUSIONS:

The 20-year probability and the population incidence of blindness due to OAG in at least 1 eye have decreased over a 45-year period from 1965 to 2009. However, a significant proportion of patients still progress to blindness despite recent diagnostic and therapeutic advancements.

PMID:
24823760
PMCID:
PMC4038428
DOI:
10.1016/j.ophtha.2013.09.003
[Indexed for MEDLINE]
Free PMC Article

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