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Founti P, Coleman AL, Wilson MR, Yu F, Harris A, Pappas T, Anastasopoulos E, Koskosas A, Salonikiou A, Keskini C, Malamas A, Kilintzis V, Raptou A, Tzoanou G, Topouzis F. Twelve-Year Incidence of Open-angle Glaucoma: The Thessaloniki Eye Study. J Glaucoma 2021; 30:851-858. [PMID: 34127627 DOI: 10.1097/ijg.0000000000001899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/23/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The objective of this study was to determine the 12-year incidence of open-angle glaucoma (OAG), with further classification into primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG), in an elderly White population. DESIGN A longitudinal, population-based study in urban Northern Greece. PARTICIPANT Surviving cohort of the 2554 Thessaloniki Eye Study subjects 60 years and above who had the baseline examination. METHODS The surviving cohort was re-examined 12 years after baseline, using the same methodology and the same standard operating procedures as in the baseline examination. The definitions of glaucoma and pseudoexfoliation were consistent throughout the study. The 12-year incidences of OAG, POAG, and PEXG with corresponding 95% confidence intervals (CIs) were calculated for the whole study population, consisting of clinic-visit and home-visit participants. The population at risk was defined as those who did not meet the study criteria for the diagnosis of glaucoma in either eye at baseline. MAIN OUTCOME MEASURES Twelve-year incidence of OAG, with further classification into POAG and PEXG. RESULTS Of 1468 eligible subjects in the surviving cohort, 1092 were examined (participation rate 74%). Mean age at baseline was 68.9±4.6 years. Mean follow-up time was 11.6±1.6 years. The 12-year incidence of OAG was 4.4% (95% CI: 3.3-5.8); 0.37% per year. In the overall population the incidence of POAG and PEXG was 2.1% (95% CI: 1.3-3.2) and 2.3% (95% CI: 1.5-3.4), respectively. The corresponding incidence proportions were 2.9 (95% CI: 1.8-4.3) in those without PEX and 8.9 (95% CI: 5.8-12.9) in those with PEX at baseline and/or incidence. The latter was strongly associated with higher odds for incident glaucoma (odds ratio=3.34, 95% CI: 1.83-6.08, P<0.001). Of all incident OAG cases, 11.1% (95% CI: 4.4-24) had baseline intraocular pressure >21 mm Hg. CONCLUSIONS The incidence of OAG was similar or higher compared with other White populations. The incidence of glaucoma in those with PEX was higher compared with the incidence of glaucoma in those without PEX.
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Affiliation(s)
- Panayiota Founti
- Glaucoma Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anne L Coleman
- Stein Eye Institute, David Geffen School of Medicine
- Departments of Epidemiology
| | | | - Fei Yu
- Stein Eye Institute, David Geffen School of Medicine
- Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Theofanis Pappas
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftherios Anastasopoulos
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Archimidis Koskosas
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Angeliki Salonikiou
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina Keskini
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Angelakis Malamas
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilis Kilintzis
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Raptou
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grigoria Tzoanou
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotis Topouzis
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Topouzis F, Founti P, Yu F, Wilson MR, Coleman AL. Twelve-Year Incidence and Baseline Risk Factors for Pseudoexfoliation: The Thessaloniki Eye Study (An American Ophthalmological Society Thesis). Am J Ophthalmol 2019; 206:192-214. [PMID: 31095955 DOI: 10.1016/j.ajo.2019.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/26/2019] [Accepted: 05/03/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To determine the 12-year incidence of pseudoexfoliation (PEX), baseline risk factors for incident PEX and risk factors for incident pseudoexfoliative glaucoma (PEXG) among those with PEX in an elderly white population. METHODS Longitudinal, population-based study in Thessaloniki, the major urban center in Northern Greece. The baseline cohort included 2554 participants ≥60 years old. The surviving cohort was re-examined 12 years later using the same methodology. PEX was defined as typical fibrillar material at the pupil margin and/or on the lens capsule. Glaucoma was defined as both structural and functional damage, irrespective of intraocular pressure (IOP). RESULTS Of 1468 eligible subjects in the surviving cohort, 1092 (74%) participated in the follow-up study. The mean age ± standard deviation (SD) at baseline was 68.9 ± 4.6 years. The mean follow-up time was 11.6 ± 1.6 years. The 12-year incidence of PEX was 19.6% (95% confidence interval (CI), 17.1-22.2), with women more likely to be affected than men (Fisher's exact test, P = .0197). Higher axial length was associated with lower odds of incident PEX (odds ratio [OR], 0.72 per mm; 95% CI, 0.57-0.92). PEX at baseline was not associated with an increased likelihood of major vascular disease (P = .9038). Higher baseline IOP (OR, 1.26 per mm Hg; 95% CI, 1.07-1.48) and history of heart attack at baseline (OR, 13.49; 95% CI, 2.85-63.87) were associated with a greater likelihood of developing PEXG among those with PEX. A history of alcohol consumption at baseline was protective of individuals developing PEXG if they had PEX at baseline. CONCLUSION This is one of the very few longitudinal population-based studies that has specifically assessed the incidence of PEX. The association with axial length was previously found only in a cross-sectional study. The associations with heart attack and alcohol consumption are new findings. In individuals with baseline PEX, higher IOP at baseline, history of heart attack at baseline, and no alcohol consumption were associated with a greater likelihood of developing glaucomatous damage approximately 12 years later. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Affiliation(s)
- Fotis Topouzis
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Panayiota Founti
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Glaucoma Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Fei Yu
- UCLA Stein Eye Institute, David Geffen School of Medicine at UCLA, University of California Los Angeles, CA, USA
| | | | - Anne L Coleman
- UCLA Stein Eye Institute, David Geffen School of Medicine at UCLA, University of California Los Angeles, CA, USA
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Liu L, Li Y, Zhang GS, Wu JY, Majithia S, Tham YC, Zhang H, Chen L. Top 100 cited articles in ophthalmic epidemiology between 2006 and 2016. Int J Ophthalmol 2018; 11:1994-1998. [PMID: 30588435 DOI: 10.18240/ijo.2018.12.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 07/12/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To identify the most-cited articles in ophthalmic epidemiology over the last decade. METHODS We performed a cited reference search on articles that were included in the ISI Web of Science database using the terms "Epidemi*" AND "ophthalm*" AND "population*" during year 2006 to 2016. TOP 100 most cited articles (T100) in ophthalmic epidemiology were short listed and analysed using bibliometrics. RESULTS These top 100 articles in ophthalmic epidemiology were cited between 61 to 333 times. Of these T100 articles, 36% originated from United States, and 34% were published in the Ophthalmology journal. The three major topics identified were age-related macular degeneration (AMD, n=23), glaucoma (n=16) and visual impairment (n=12). The top-cited article was a study on outdoor activities and its association with the prevalence of myopia in school-aged children, published in 2008. CONCLUSION This bibliometric analysis provides useful insights into the current development in ophthalmic epidemiology in the past decade and can help recognizing the quality of the researches, discoveries, and trends steering ophthalmic epidemiology.
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Affiliation(s)
- Lei Liu
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.,Department of Public Service, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.,Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore
| | - Yan Li
- Department of English, School of Fundamental Sciences, China Medical University, Shenyang 110122, Liaoning Province, China
| | - Gui-Sen Zhang
- Department of Ophthalmology, Hohhot Chao Ju Eye Hospital, Hohhot 010052, Inner Mongolia Autonomous Region, China
| | - Jing-Yang Wu
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore
| | - Han Zhang
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Lei Chen
- Department of Ophthalmology, First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.,Liaoning Diabetic Eye Center, Shenyang 110001, Liaoning Province, China
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