kebutaan glaukoma & late presentation

8/13/2019 Kebutaan Glaukoma & Late Presentation

1/11

PMC3032239

Indian J Ophthalmol. 2011 Jan-Feb; 59(1) 29!35.doi 10."103#0301-"$3%.$3$20PMCI& PMC3032239

Is glaucoma blindness a disease of

deprivation and ignorance? A casecontrol

study for late presentation of glaucoma in

India

Pa'ihit *o+ate,oma &ehpande,id/a Chele'a', apna &ehpande,1and Madan&ehpandetho' in4o'mation 'ti6le note Cop/'i+ht and 7i6ene in4o'mation 8hi a'ti6le ha been 6ited b/othe' a'ti6le in PMC.*o to

Abstract

Aim:

8he aim a to identi4/ the p'eentin+ /mptom and o6ial 'i 4a6to' 4o' late p'eentationo4 p'ima'/ +la6oma in nel/ dia+noed 6ae.

Materials and Methods:

It a a 6ae-6ont'ol td/ in a te'tia'/ e/e 6a'e 6ente' in Maha'aht'a, India. el/dia+noed patient ith p'ima'/ +la6oma e'e 6lai4ied a 6ae (late p'eente') he'e

the'e a no pe'6eption o4 li+ht in one e/e o' e:e'e :ial 4ield lo a44e6tin+ an a'ea ithin20 o4 4i 0.001, odd 'atio A 0.0$; 95@ CI, 0.02!0.25). Bnoled+e
http://dx.doi.org/10.4103%2F0301-4738.73720http://www.ncbi.nlm.nih.gov/pubmed/?term=Gogate%20P%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Gogate%20P%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20R%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20R%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Chelerkar%20V%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20S%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20S%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20M%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20M%5Bauth%5Dhttp://void%280%29/http://void%280%29/http://void%280%29/http://void%280%29/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032239/citedby/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032239/citedby/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032239/#ui-ncbiinpagenav-2http://www.ncbi.nlm.nih.gov/pubmed/?term=Gogate%20P%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20R%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Chelerkar%20V%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20S%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20M%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Deshpande%20M%5Bauth%5Dhttp://void%280%29/http://void%280%29/http://void%280%29/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032239/citedby/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032239/#ui-ncbiinpagenav-2http://dx.doi.org/10.4103%2F0301-4738.73720


2/11

o4 4amil/ hito'/ o4 +la6oma (PA 0.%0, odd 'atio A 1.1; 95@ CI, 0.3!3.$1) and e/e 6lini6attendan6e in pat 2 /ea' till 'elted in late p'eentation (PA 0."5, odd 'atio A 1.3", 95@CI, 0.3!2.%2).

Conclusion:

7a6 o4 ed6ation and aa'ene o4 +la6oma e'e maDo' 'i 4a6to' 4o' late p'eentation.

Keywords: a'ene, blindne, dep'i:ation, +la6oma, late p'eentation

*la6oma i one o4 the leadin+ 6ae o4 blindne in mot pa't o4 the o'ld.E1!% &epitene medi6al and '+i6al t'ate+ie to 6ont'ol int'ao6la' p'e'e (IOP), blindne 6aed b/+la6oma 6ontine to in6'eae, and +la6oma 'emain the e6ond o' the thi'd mot 6ommon6ae o4 blindne in the o'ld.E9,10 +la6oma i a dieae ith 4e /mptom in initialta+e, late p'eentation i 6ommon and, hen :ial 4ield lo th'eaten 6ent'al :iion, i animpo'tant 'i 4a6to' 4o' blindne.E11,12

Ghile the'e ha:e been 4e tdie demont'atin+ the ao6iation o4 late p'eentation o4+la6oma ith o6ial 4a6to' 4'om the HB,E13,1" the'e ha been none 4'om India he'e+la6oma i a i+ni4i6ant 6ae o4 blindne.E$ 7a6 o4 aa'ene abot +la6oma alo6ont'ibte to it late p'eentation. In the a'bado /e td/ (), abot hal4 o4 the totalnmbe' o4 pe'on ith p'e:alent p'ima'/ open an+le +la6oma (PO*, 51@) e'e naa'eo4 thei' dia+noi.E15 ome 6ommnitie in de:eloped 6ont'ie lie the HB too had la6 o4aa'ene.E1 8he ndh'a P'adeh /e &ieae td/ (P&) hoed that aa'ene o4+la6oma a :e'/ limited in the ''al a'ea o4 othe'n India.E1$ 8o o' noled+e no6h td/ ha been 6ond6ted in Maha'aht'a in ete'n India.

Ge nde'too a 6ae!6ont'ol td/ to dete'mine the ao6iation beteen o6ial 4a6to',aa'ene, and late p'eentation o4 +la6oma in a te'tia'/ e/e 6a'e 6ente' in Maha'aht'a,Get India.

*o to

Materials and Methods

hopital-baed 6ae!6ont'ol td/ a 6ond6ted in:ol:in+ patient dia+noed ithp'ima'/ +la6oma 4o' the 4i't time at :iit to a te'tia'/ e/e 6a'e 6ente' in Pne, Maha'aht'a,India.

el/ dia+noed patient ith p'ima'/ +la6oma e'e ele6ted. 6omplete ophthalmi6e


3/11

Patient e'e 6lai4ied a ea'l/ and late p'eente' in+ the 4olloin+ 6'ite'ia ea'l/p'eente' (6ont'ol) had :ial 4ield ith no abolte 6otoma ithin 20 o4 4i0.% o' a di44e'en6e o4 ?0.2 beteen the to e/e. 7ate p'eente' (6ae) hadno pe'6eption o4 li+ht o' e:e'e :ial 4ield lo a44e6tin+ an a'ea ithin 20 o4 4i


4/11

p'eentation o4 +la6oma. 8he patient e'e not aa'e o4 thei' 6ae o' 6ont'ol tat. pilottd/ a 6ond6ted 4i't. 8he data 6olle6tion 4o'm i en6loed appendi< .

One hnd'ed +la6oma patient in ea6h +'op o4 ea'l/ and late p'eente' e'e en'olled todete6t i4 the'e a a 10@ di44e'en6e, beteen the loe' and hi+he' o6ioe6onomi6 6la at

%0@ poe' ith a 95@ 6on4iden6e le:el.

&ata e'e p'eented ith mean (tanda'd de:iation, &) o' nmbe' (@) in the 6ae o46ontino o' 6ate+o'i6al data, 'epe6ti:el/. In the tatiti6al anal/i, :a'iable ith eeddit'ibtion e'e lo+-t'an4o'med to ati4/ the amption o4 no'malit/. Fo' 6ontino:a'iable, the mean di44e'en6e beteen +'op a teted in+ the independent t-tet, andin+ the 6hi-a'e tet o' Fihe' e


5/11

PC* 6ae p'eented ith 'edne, 6olo'ed halo, and heada6he. Colo'ed halo e'e alop'eent in PO* 6ae; thi ma/ be att'ibted to lenti6la' opa6it/ in thee 6ae. Motpatient p'eented ith mo'e than one /mptom.

8able "ho the o6ial 'i 4a6to' 4o' late p'eentation o4 +la6oma. 8'a:el time and

e


6/11

mon+ the PO* patient, "$.$@ e'e ea'l/ p'eente' and 52.3@ e'e late p'eente'.mon+ PC* patient, 5$@ e'e ea'l/ p'eente' and "3@ e'e late p'eente'. 8hi td/hoed that p'o4eional 6ommonl/ p'eented hi+he' in6iden6e o4 PO* and loe'in6iden6e o4 PC*, a 6ompa'ed to nemplo/ed and loe' o66pational +'op patient (PA0.05), a hon in 8able 5. Female e'e mo'e liel/ to ha:e PC* (PA 0.001) than PO*.

8able 5nal/i o4 the p'eentin+ patte'n and t/pe o4 +la6oma

8able ho the 'elationhip o4 o6ial 4a6to' ith aa'ene abot +la6oma.

8able

nal/i o4 o6ial 4a6to' and aa'ene o4 +la6oma

Onl/ 1$ (%.5@) patient e'e aa'e o4 +la6oma. 8hoe ho e'e aa'e o4 +la6oma e'e/on+e' a 6ompa'ed to thoe naa'e (PA 0.015). a'ene o4 +la6oma a hi+he'amon+ thoe ha:in+ a poiti:e 4amil/ hito'/ (P> 0.001). i+ht ot o4 20 ("0@) patient itha poiti:e 4amil/ hito'/ had in6omplete in4o'mation abot +la6oma. a'ene a poo'amon+ both +ende'; 4amil/ membe' and o66pational 6lae and +'ade o4 o66pation didnot a44e6t aa'ene o4 +la6oma (PA 0.2$). a'ene o4 +la6oma a poo' in allned6ated 6la patient, bt a li+htl/ hi+he' in ed6ated patient (9.%@) than in illite'ate

patient (5.3@); bt thi a tatiti6all/ ini+ni4i6ant (PA 0.5%).

*o to

iscussion

*'adal painle diminihin+ :iion a the mot 6ommon /mptom 4o' p'eentation.*la6oma a an in6idental 4indin+ in the maDo'it/ o4 6ae in o' td/. 8hi p'o:e theimpo'tan6e o4 6omp'eheni:e e/e e


7/11

6o''obo'ated the 4indin+ o4 to poplation-baed tdie 4'om India, the P&E20 and theChennai *la6oma td/.E21

o6ioe6onomi6 tat a a 'i 4a6to' 4o' late p'eentation o4 +la6oma. 'e6ent td/ 4'om6otland, HB, hoed that a'ea ith hi+he' inde< o4 dep'i:ation had mo'e e:e'e +la6oma

on p'eentation to the health /tem.E22

*la6oma tend to 'n in 4amilie.E",23!25 td/ 4'om oton hoed that people hohad a 4i't-de+'ee 'elati:e ith +la6oma e'e mo'e aa'e o4 the dieae.E2 InMoo'e4ieldK /e Lopital td/, it a obe':ed that t'on+e' the patientK 4amil/ hito'/,the loe' the odd o4 late attendan6e.E13,1" t in o' td/, e:en patient ith a poiti:e4amil/ hito'/ e'e liel/ to p'eent late a aa'ene o4 +la6oma a :e'/ poo'. Pe'hapthe ophthalmolo+it ho t'eated the a44e6ted 4amil/ membe' did not tae time to 6onel the

patient that the dieae 'n in 4amilie and all iblin+ and 6hild'en hold nde'+o a 'e+la'6omp'eheni:e e/e e


8/11

6o4a6to' in the mlti:a'iate lo+iti6 'e+'eion model. lo the'e a la6 o4 aa'ene o4+la6oma amon+ all b+'op and ome 6ae e'e mied on p'e:io e


9/11

ata collection form

C& 'atio

*onio6op/

ial 4ield lo

nte'io' e+ment

Pote'io' e+ment

&ia+noi

8'eatment

Pla6e o4 'eiden6e H'ban#''al

o6ial hito'/

O66pation o4 head o4 4amil/-

d6ation o4 head o4 4amil/-

Loin+- a66ha#p66a

mbe' o4 people in the hoehold-

Pe' 6apita in6ome

o6ioe6onomi6 +'ade (a pe' Bppam/#P'aad 6lai4i6ation)-

tat in 4amil/- ea'nin+#nonea'nin+

elation to head o4 4amil/-

&i44i6lt/ in na:i+ation- /e#no

44o'dabilit/ o4 t'eatment- /e#no

Bnoled+e abot +la6oma- hat i it &o /o no the impo'tan6e o4 +ood

6omplian6e 'e /o aa'e o4 it 'elationhip ith 4amil/ hito'/ ole o4 int'ao6la'p'e'e Ghat i 4ield lo I +la6oma blindne t'eatable

Complian6e o4 t'eatment /e#no

Famil/ hito'/ o4 +la6oma /e#no

ttended e/e 6lini6#e/e 6he6-p in pat 2 /ea' /e#no

Che6-p a done b/ ophthalmolo+it#optomet'it

8he p'eentation o4 +la6oma ea'l/#late

&ia+'am 4o' 6p di6 'atio

*o to

$ootnotes
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032239/#ui-ncbiinpagenav-2http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032239/#ui-ncbiinpagenav-2


10/11

%ource of %upport:il

Conflict of Interest:one de6la'ed.

*o to

References

1. Pa6olini &, Ma'iotti P, Poha'el *P, Pa'a'aDae+a'am , K8al/e &, e+'el &, et al.2002 +lobal pdate o4 a:ailable data in :ial impai'ment 6ompilation o4 poplation baed

p'e:alen6e tdie. Ophthalm pidemiol. 200";11$!115.2. Coo C. *la6oma in 4'i6a ie o4 the p'oblem and poible oltion. *la6oma.2009;1%12"!%.3. Con+don . ed6in+ the :ial b'den o4 +la6oma in ia Ghat e no and hat eneed to no. J *la6oma. 2009;1%%%!92. EPbMed

". Bhandea' , Ja44e' M, l aii , Qthi , Mahabaleha' M, hah , et al. Oman/e td/ 2005 P'e:alen6e and dete'minant o4 +la6oma. at Medite'' Lealth J.200%;1"13"9!59. EPbMed5. &andona 7, &andona , 'ini:a M, Mandal P, John B, M6Ca't/ C, et al. Open-an+le*la6oma in an H'ban Poplation in othe'n India, 8he ndh'a P'adeh /e &ieae td/.Ophthalmolo+/. 2000;10$1$02!9. EPbMed. Palima' , Bhandea' , entata'aman . P'e:alen6e and dit'ibtion o4 +la6oma in6ent'al India. Ind J Ophthalmol. 200%;55$!2.$. eena J, a6hel J, P'a:een , M'th/ *. apid ement o4 :oidable lindneIndia td/ *'op. apid ement o4 :oidable lindne India. P7o One.200%;3e2%$. EPMC 4'ee a'ti6le EPbMed

%. 7ee MC, Connell m, 6ha6hat P, L/man 7. 8he a'bado /e td/. P'e:alen6e o4open an+le +la6oma. '6h ophthalmol. 199";112%21!9. EPbMed9. Ri+el/ L, o'man 8. 8he nmbe' o4 the people ith +la6oma o'ldide in 2010and 2020. ' J Ophthalmol. 200;9022!$. EPMC 4'ee a'ti6le EPbMed10. *'ant GM, 'e JF. Gh/ do ome people +o blind 4'om +la6oma Ophthalmolo+/.19%2;%9991!%. EPbMed11. Gilon , Gale' , &ee' &B, C'i6 P. i 4a6to' 4o' 'ate o4 p'o+'eion o4+la6omato :ial 4ield lo 6ompte' baed anal/i. '6h Ophthalmol. 19%2;100$3$!"2. EPbMed12. C'onembe'+e' , 7o'en6o 7F, il:a 7C, Cali


11/11

1%. P'aad *. Chan+e p'opoed in o6ial 6lai4i6ation o4 Indian 4amilie. J Indian Medo6. 19$0;5519%!9. EPbMed19. Bppami . &elhi Mana/an; 19%1. Manal o4 o6io-e6onomi6 6ale ('ban)20. th &andona 7, &andona , Mandal P, 'ini:a M, John B, M6Ca't/ C, et al. n+le-6lo'e +la6oma in an 'ban poplation in othe'n India. 8he ndh'a P'adeh e/e dieae

td/. Ophthalmol. 2000;10$1$10!.21. iDa/a 7, *eo'+e , 'a:ind L, aD P, e ameh , Bma'amani6a:el *, et al.P'e:alen6e o4 an+le 6lo'e dieae in an 'ban oth Indian poplation and 6ompa'iion ith''al poplation. 8he Chennai *la6oma td/. Ophthamol. 200%;11555!0.22. + G, +a'al PB, idii , Ma6a/ 7, 8onend J, a'a lan6o . 8he 44e6t o4o6ioe6onomi6 &ep'i:ation on e:e'it/ o4 *la6oma at P'eentation. ' J Ophthalmol.2010;9"%5!$. EPbMed23. 7ee MC, G S, Lenni , Lonanen , eme'e . td/ *'op. iFa6to' 4o' in6ident open-an+le +la6oma the a'bado /e tdie. Ophthalmol.200%;115%5!93.2". 8iel6h JM, omme' , Gitt B, Bat J, o/all M. lindne and :ial impai'ment in

an me'i6an 'ban poplation. '6h Ophthalmol. 1990;10%2%!290. EPbMed25. Gol4 C, Bla:e' CC, am'attan , :an &iDn CM, Lo4man , de Jon+ P8. *eneti6'i o4 p'ima'/ open-an+le +la6oma. Poplation-baed 4amilial a++'e+ation td/. '6hOphthalmol. 199%;111"0!5. EPbMed2. *a6h 8, Gan+ P, Paale 7. &ete'minant o4 +la6oma aa'ene in a +ene'al e/e6lini6. Ophthalmol. 2000;10$303!%.2$. ath/aman+alam , Pal P*, *eo'+e , haa'an M, Lemamalini , Madan aD , etal. &ete'minant o4 +la6oma aa'ene and noled+e in 'ban Chennai. Ind J Ophthalmol.2009;5$355!0.2%. ltan+e'el H, allamhett/ L, Hhle' 8, Fontana'oa J, teinmann GC, lmodin JM, etal. Bnoled+e abot +la6oma and ba''ie' to 4ollo-p 6a'e in a 6ommnit/ +la6oma6'eenin+ p'o+'am. Can J Ophthalmol. 2009;""!9. EPbMed29. ttebo B, Mit6hell P, Cmmin+ , mith G. Bnoled+e and belie4 abot 6ommon e/edieae. t Q J Ophthalmol. 199$;252%3!$. EPbMed30. de+behin+be O, ii'i/ 7. Bnoled+e, attitde, and el4 6a'e p'a6ti6e ao6iatedith +la6oma amon+ hopital o'e' in Ile-I4e, On tate, i+e'ia. 8anan J Lealth e.200%;102"0!5. EPbMed31. ae' L, M'do6h I. Can a pbli6 health inte':ention imp'o:e aa'ene and health-eein+ beha:io' 4o' +la6oma ' J Ophthalmol. 200%;921$1!5. EPbMed
http://www.ncbi.nlm.nih.gov/pubmed/5501467http://www.ncbi.nlm.nih.gov/pubmed/19628488http://www.ncbi.nlm.nih.gov/pubmed/2271016http://www.ncbi.nlm.nih.gov/pubmed/9869795http://www.ncbi.nlm.nih.gov/pubmed/19169316http://www.ncbi.nlm.nih.gov/pubmed/9395831http://www.ncbi.nlm.nih.gov/pubmed/19402586http://www.ncbi.nlm.nih.gov/pubmed/18838409http://www.ncbi.nlm.nih.gov/pubmed/5501467http://www.ncbi.nlm.nih.gov/pubmed/19628488http://www.ncbi.nlm.nih.gov/pubmed/2271016http://www.ncbi.nlm.nih.gov/pubmed/9869795http://www.ncbi.nlm.nih.gov/pubmed/19169316http://www.ncbi.nlm.nih.gov/pubmed/9395831http://www.ncbi.nlm.nih.gov/pubmed/19402586http://www.ncbi.nlm.nih.gov/pubmed/18838409

kebutaan glaukoma & late presentation

Documents