K 352
Risk factors in primary open angle glaucoma in relation to the stage of the disease
E. Gramer, G. Gramer, A. Wettengel
Purpose: Prospective evaluation, whether patients with primary open angle glaucoma (POAG) with advanced stages compared to patients with beginning stages of the disease show differences:1. In the frequency of family history of glaucoma ( FHG) 2. In the frequency of migraine 3. In the frequency of cardiac diseases 4. In the age of the patient at the time of diagnosis.
Methods: By means of a questionnaire addressed to patients and their ophthalmologists we evaluated the relation of the stage of the disease with: 1. the frequency of FHG (1312 patients), 2. the frequency of migraine (1222 patients ) 3. frequency of cardiac diseases (1242 patients ) and 4. age of the patient at the time of diagnosis (1250 patients). According to the severity of visual field loss (VFL)in the eye with the more severe VFL we seperated four groups (I-IV):I no VFL.II beginning VFL(stage I and II ,according to the classification of Aulhorn).III moderate VFL (stage III and IV).IV severe VFL (stage V).
Results: There was no significant difference between groups in the frequency of FHG( 41,2% vs.40,2%vs.38,4% vs.47,2%) and in the frequency of migraine (13,7% vs.12,2% vs.11,4% vs.14,8%).The more severe the stage of the disease the higher was the frequency of cardiac diseases (19,3%vs.25,3%vs. 34,3%vs. 34,9%,p=0,001Cochran-Armitage-Trend-Test).Patients with more advanced stages of the disease showed a significant higher age at the time of diagnosis ( 52,3 ± 12,9 years vs.55,9 ± 11,2 years vs.57,7 ± 11,7 years vs. 60,4 ± 12,0 years ( p=0,0001, ANOVA-Test).Patients with FHG compared to patients without FHG showed a significant younger age at the time of diagnosis (p=0,0001,Fisher`s Exact-Test, two-tale).
Conclusion: Age of the patient at the time of diagnosis and a cardiac disease, which might be age related ,are risk factors for VFL. Screening for glaucoma in relatives of glaucoma patients is significant for early diagnosis, because the prognosis of POAG is dependent on the time of diagnosis.
University Eye Hospital Würzburg, J.-Schneider-Str.11, D-97080 Würzburg