Frequencies of 4 Distinct Patterns of Glaucomatous Disc Appearance and Their Clinical Associations in Japanese Population-based Studies.
Iwase Aiko, Araie Makoto, Kuwayama Yasuaki, Murata Hiroshi, Yamamoto Tetsuya
AI Summary
This study found focal glaucomatous discs are most common in Japanese POAG, followed by generalized enlargement. Distinct patterns were linked to age, BMI, and ocular parameters, aiding personalized glaucoma management.
Abstract
Purpose
To study the frequencies and factors associated with 4 disc patterns in primary open-angle glaucoma (POAG) identified in population-based studies: focal glaucomatous (FG type), generalized enlargement of cup (GE type), myopic glaucomatous (MG type), and senile sclerotic glaucomatous (SS type) patterns.
Subjects
In total, 270 disc photographs of acceptable quality were extracted from the records of 270 definitive POAG cases diagnosed according to the International Society of Geographical and Epidemiological Ophthalmology Criteria in 2 Japanese population-based glaucoma surveys. One randomly chosen eye from the bilateral POAG cases was included.
Results
Using a method of κ coefficient of reproducibility of classification of 0.80 according to a preliminary study, 143 discs were classified as FG, GE, MG, or SS types with respective frequencies of 57% (95% confidence interval [CI], 48-66), 33% (95% CI, 25-42), 7% (95% CI, 3-13), and 3% (95% CI, 0-7), and 127 discs as the miscellaneous type. Multinomial logistic regression analysis showed that the MG type was associated (P=0.052, 0.025, 0.019, and 0.018) with younger age, lower body mass index (BMI), and greater disc area and ovality, and the GE type was associated (P<0.001, 0.036, and 0.056) with greater disc area, corneal radius, and hyperopic refraction than the FG type.
Conclusions
The FG type occurs most frequently in Japanese POAG followed by the GE type. The MG and SS types occurred much less often than previously reported in Japanese. Associations with age, BMI, disc area and ovality, refraction, and corneal radius differed among the FG, GE, and MG types.
MeSH Terms
Shields Classification
Key Concepts6
In Japanese population-based studies, the focal glaucomatous (FG) type of disc appearance was the most frequent among 4 distinct patterns of glaucomatous disc appearance, occurring in 57% (95% confidence interval [CI], 48-66) of 143 classified discs from 270 primary open-angle glaucoma (POAG) cases.
In Japanese population-based studies, the generalized enlargement of cup (GE) type of disc appearance was the second most frequent among 4 distinct patterns of glaucomatous disc appearance, occurring in 33% (95% CI, 25-42) of 143 classified discs from 270 primary open-angle glaucoma (POAG) cases.
In Japanese population-based studies, the myopic glaucomatous (MG) type of disc appearance was found in 7% (95% CI, 3-13) of 143 classified discs from 270 primary open-angle glaucoma (POAG) cases, which was much less often than previously reported.
In Japanese population-based studies, the senile sclerotic glaucomatous (SS) type of disc appearance was found in 3% (95% CI, 0-7) of 143 classified discs from 270 primary open-angle glaucoma (POAG) cases, which was much less often than previously reported.
Multinomial logistic regression analysis of 143 classified discs from 270 primary open-angle glaucoma (POAG) cases in Japanese population-based studies showed that the myopic glaucomatous (MG) type was associated with younger age (P=0.052), lower body mass index (BMI) (P=0.025), and greater disc area (P=0.019) and ovality (P=0.018) compared to the focal glaucomatous (FG) type.
Multinomial logistic regression analysis of 143 classified discs from 270 primary open-angle glaucoma (POAG) cases in Japanese population-based studies showed that the generalized enlargement of cup (GE) type was associated with greater disc area (P<0.001), corneal radius (P=0.036), and hyperopic refraction (P=0.056) compared to the focal glaucomatous (FG) type.
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