Original research: Progression to severe visual impairment and blindness in POAG patients: pace and risk factors—a cohort study using German health claims data

BMJ Open Ophthalmology

article

Sophia Nestler¹  Daniel Kreft¹  Gabriele Doblhammer¹  Rudolf F Guthoff³  Stefanie Frech³ 

[1] Institute for Sociology and Demography , University of Rostock;German Centre for Neurodegenerative Diseases;Department of Ophthalmology , Rostock University Medical Center

关键词: glaucoma;    vision;    public health;    epidemiology;   

DOI  :  10.1136/bmjophth-2021-000838

学科分类：工业工程学

来源: BMJ Publishing Group

【 摘 要 】

Objective Glaucoma is a leading cause of severe visual impairment and blindness (SVI/B) worldwide. Hence, it is of utmost importance to explore relevant risk factors and study the pace of progression to SVI/B.Methods and analysis We used a random sample of 250 000 persons from administrative individual-level health records of the Allgemeine Ortskrankenkassen between 2004 and 2015. We identified 3535 primary open-angle glaucoma (POAG) patients aged 55 and older and followed them for up to 10 years. Monocular and binocular SVI/B were defined by the ICD-10 classifications H54.0 and H54.4. Ophthalmological and chronic disease risk factors were analysed by applying a multivariable Cox proportional hazard model.Results The risk of SVI/B in POAG patients was significantly increased by the presence of specific additional eye diseases such as secondary glaucoma (HR: 3.08, p<0.001), retinal vascular occlusion (HR: 3.00, p<0.001) or age-related macular degeneration (AMD) (HR: 2.26, p0.05).Conclusion Although progression to SVI/B is relatively rare in POAG patients in Germany, one must be aware of additional risk factors, such as secondary glaucoma, retinal vascular occlusion and AMD. Regular ophthalmological examinations help prevent the progression of SVI/B, especially in the first years after the POAG diagnosis. Specific, targeted, and timely treatments for the other eye diseases could help prevent or delay SVI/B.

【 授权许可】

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