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Section 2. Life science
DOI:10.29013/EJBLS-23-4-11-15
INCIDENCE AND PREVALENCE OF GLAUCOMA IN GEORGIA
Salome Tabatadze 1, Nino Tkhelidze 1, Otar Vasadze 1
1 University of Georgia, Tbilisi, Georgia
Cite: Tabatadze, S., Tkhelidze, N., Vasadze, O. (2023). Incidence and Prevalence of Glaucoma in Georgia. The European Journal of Biomedical and Life Sciences 2023, No 4 https://doi. org/10.29013/EJBLS-23-4-11-15
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide and is associated with a reduced quality of life. Patients with arterial hypertension, diabetes, family history, age more than 50 years are at an increased risk of glaucoma.
The current number of persons (aged 40-80 years) with glaucoma worldwide is 64.3 million and is expected to increase to 111.8 million in 2040. Asia accounts for the largest number of glaucoma cases despite having the lower prevalence of glaucoma.
The aim of our investigation was to study the incidence and prevalence of Glaucoma in Georgia, its specific share compared to other eye diseases. The obtained epidemiologic data were adjusted by age, sex and regions.
Keywords: glaucoma, incidence, prevalence, epidemiology
Introduction
Glaucoma is one of the serious, chronic, multifocal eye diseases, which is characterized by constant or periodic increase of intraocular pressure, characteristic changes in the field of vision (Tham, et al, 2014; Thomas, et al, 2015). Typically glaucoma remains asymptomatic until very severe. During glaucoma, damage to the optic disc and retinal ganglion cells, characteristic of glaucoma, develops - glaucomatous optic neuropathy. These changes lead to vision loss and even to complete blindness. Glaucoma is the leading cause of irreversible blindness worldwide. Most common type of Glaucoma is Primary Open Angle Glaucoma (POAG)
Risk factors
Among the risk factors, I would single out the family history, the genetic factor and predisposition are very important, which increases the risk of developing this disease tenfold. Around half of all primary OAG patients have a positive family history, and their first degree relatives (parents, siblings or children) have an approximately 9-fold increased risk of developing glaucoma (Awadalla, et al., 2015).
Risk factors include age and frailty, gender, myopia, genetics, smoking, race, systemic hypertension and hypertension, vaso-spasm, use of systemic or topical steroids,
migraine, obstructive sleep apnea syndrome, and most significantly, increased IOP (Mc-Monnies, CW, 2017).
Other risk factors also include: eye trauma, narrow front cell, other eye diseases, pseudoexfoliation, etc.
Statistics
Staropoli et al. (2021) indicated that 2.4 million people in the United States alone are at risk of glaucoma, and worldwide the number of glaucoma patients will increase to 111 million by 2040. According to WHO estimates, by 2010 glaucoma accounts for 8% of global blindness, its number is increasing, by 2020 it reached - 13% (Staropoli, et al., 2021). In the United States, blindness is the third most dangerous health problem, after cancer and heart attack.
The prevalence of glaucoma increases with age and can thus be associated with age-related diseases like macular degeneration, vascular diseases, and obstructive sleep ap-nea. POAG is strongly correlated with age: its prevalence is highest among older Hispanic or Latino (18%), black (15%), white (7%), and Asian individuals (5%). Finally, there are gender differences in glaucoma as well. There was a reported 36% higher prevalence of glaucoma in males than females (Mc Monnies, 2017).
Prevalence of Glaucoma
2015 Nigeria Blindness Survey is so far the largest national population-based survey of eye disease in an ethnically diverse, indig-
enous black African population. They have described precise estimates of the prevalence of glaucoma in this region. The study sample was nationally representative by age, gender, ethnicity, rural/urban residence, and socioeconomic status with a high response rate. The results were generalizable to the whole country and people of the West African diaspora around the world (Kyari, et al., 2015).
The most common type of glaucoma in the UK is POAG, affecting 2% of individuals older than 40 years and 10% of individuals older than 75 years, particularly African-Caribbean population; PACG is not as prevalent and only affects 0.17% of individuals younger than 40 years, particularly East Asians (Imrie, C., Tatham, A. J., 2016). 7.8 million Persons were affected by POAG in Europe and the total prevalence is 2.51% (Allison, et al., 2020).
Prevalence of Glaucoma in Georgian
We collected the data from National Center For Disease Control and Public Health of Georgia.
For both sexes crude rate of the glaucoma incidence per 100,000 person was 61.2; age-standardized rate (ASR) - 35.6; age-adjusted rate (AAR) - 61.2; cumulative risk up to 69 years (CR0+69) - 1.44; cumulative risk up to 79 years (CR0+79) - 2.86; cumulative risk above 80 years (CR0+80) - 3.93. As we can see it from Figure 1 incidence of Glaucoma is rising depending on the age.
Figure 1. The age-specific incidence of glaucoma for both sexes in Georgia, 2020-2022
Figure 2. The incidence of POAG for both sexes in Georgia, 2020-2022
POAG is most common type of glaucoma in Georgia. As we can see it from Figure 2, from 2020 it was rising from 861 cases to 1536. It was as high as 1536 in 2022, the same as in 2021.
As we can see it from the Figure 3 the incidence of Glaucoma was higher in Males then in Females and it was rising with the age. Crude rate per 100,000 person at the age of 50-59 there were 41.7 cases in female population, and 68.1 cases in male population. In the age of 60-69 this number is 3.5-fold more compared to the previous age (50-59) in both sexes. The amount
of glaucoma cases continued to increase in the next age group 70-79; glaucoma cases per 100,000 population in female population increased 1.4-times, and for male population it was higher by 1.7 times in age group 70-79 then in age group 60-69. As for the next age group, the amount of glaucoma was decreased as the population of this age group itself was also decreased.
The share of Glaucoma in Georgia for both sexes in 2007 was 10.0% out of all eye diseases, in 2013 it was the highest - 10.4% of all eye diseases and in 2022 it was dropped to 4.0% (see Figure 4).
Figure 3. Age- and sex-specific distribution of patients (per 100,000 person) with Glaucoma in Georgia 2020-2022
Figure 4. The share of Glaucoma in all eye diseases, both sexes, Georgia, 2007-2022.
Discussion
Prevention of blindness caused by glaucoma
Despite modern advances in medicine, glaucoma remains a major public health problem worldwide.
For the prevention of glaucoma, it is necessary to prevent it, which means timely screening visits to an ophthalmologist.
It is also a very noteworthy fact that the awareness of glaucoma is quite low. The data of studies performed in developed countries showed that the awareness of glaucoma reaches 50%; while in developing countries 90% of population did not know that they are sick with glaucoma. One of the reasons for this fact is that the disease goes almost silently to the late stage and the patient does not even realize that he is losing his sight (Allison, et al., 2020).
Since glaucoma is one of the leading causes of vision loss, glaucoma can affect many aspects, first of all, the quality of life of the patients and disrupt the ability to perform such daily activities as reading, walking, driving, moving.
The main goal of glaucoma treatment and management is to preserve the patient's vision and improve the quality of life.
Delayed diagnosis was associated with an increased risk of glaucoma-related disability and significantly reduced the quality of life.
Conclusion
The incidence of Glaucoma in Georgia is higher in Male then in Female and it is rising with the age. In the age of 60-69 number of glaucoma cases was 3.5 times more compared to the previous age (50-59) in both sexes. The amount of glaucoma cases continues to increase in the next age group 70-79. The study was conducted with data from2007 to 2022 which was accompanied by changes in the health care system and the Covid-19 pandemic, so it requires the further assessment.
Recommendations
It is necessary to make global changes to reduce the incidence of glaucoma and stop it from being a bigger public health threat. Some recommendations include the regular glaucoma screenings, and the stronger education. People with a high-risk factor for glaucoma - a family history of glaucoma -should be educated about it and screened for it as soon as possible.
Glaucoma awareness needs to be raised. January is Glaucoma Awareness Month. Public awareness campaigns, whether seminars, flyers, websites or posters, can reach the public and show them the importance of early diagnosis and early treatment to prevent blindness from glaucoma.
References
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Kyari, F., Entekume, G., Rabiu, M., et al. (2015). A Population-based survey of the prevalence and types of glaucoma in Nigeria: results from the Nigeria National Blindness and Visual Impairment Survey. BMC Ophthalmol.,- 15.- 176 p. Doi: 10.1186/s12886-015-0160-6
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Tham, Y. C., Li, X., Wong, T. Y., Quigley, H. A., Aung, T., Cheng, C. Y. (2014). Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology,- 121(11).- P. 2081-2090. Doi: 10.1016/j.oph-tha.2014.05.013
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submitted 09.11.2023;
accepted for publication 29.11.2023;
published 26.01.2024
© Tabatadze S., Tkhelidze N., Vasadze O.
Contact: tabatadze.salome85@gmail.com, info@ug.edu.ge.
