Emerging Trends in The Pattern of Presentation and Risk Factors of Severity of Primary Open Glaucoma in A Tertiary Hospital in Southern Nigeria.

Aim: The aim of this study was to determine the current trend in the pattern of presentation and associated risk factors for advanced/end-stage glaucoma in patients attending a tertiary hospital in southern Nigeria.Methods: Records of 324 patients with a diagnosis of primary open angle glaucoma seen consecutively over a 24-month period were reviewed. Data extracted included socio-demographic information and clinical findings such as visual acuity, vertical cup-disc ratio and intraocular pressure. Two levels of severity were defined; mild/moderate and advanced/end-stage. Univariate and multivariable analysis were undertaken to determine independent risk factors for severity.Results: There were more males 174 (53.7%) and the mean (SD) age was 52.24 (+18.00) years. Two hundred and forty-seven persons (76.2%) had normal vision, 27 (8.3%) were visually impaired and 49 (15.1%) were blind in the better eye. The mean (SD) VCDR for RE and LE were 0.76 (+0.17) and 0.76 (+0.16) respectively. Overall 183 (56.5%) had mild/moderate disease while 141 (43.5%) had advanced /end-stage disease. Independent risk factors for more severe disease were increasing age and intraocular pressure greater than 21mmHg. Adjusted OR for age: 40-59 [2.92 (CI:1.23-6.95), p=0.015]; ≥60 [Adjusted OR: 7.76 (CI:3.12- 9.31), p 21mmHg [Adjusted OR: 4.36 (CI: 2.53 -7.52), p<0.0001]. Conclusion: Over two-fifths of glaucoma patients presented with advanced disease, however the pattern is better than reported from previous studies. Awareness creation and screening for glaucoma should be sustained to reduce the incidence of glaucoma blindness