Clinical Epidemiology (Dec 2020)
Detection of Glaucoma and Other Vision-Threatening Ocular Diseases in the Population Recruited at Specific Health Checkups in Japan
Abstract
Masakazu Yamada,1 Yoshimune Hiratsuka,2 Tadashi Nakano,3 Yoshiyuki Kita,1 Tomoyuki Watanabe,3 Hiroshi Tamura,4,5 Ryo Kawasaki,6 Tetsuji Yokoyama,7 Shigeru Takano8 1Department of Ophthalmology, Kyorin University School of Medicine, Mitaka, Japan; 2Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan; 3Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan; 4Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; 5Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan; 6Artificial Intelligence Center for Medical Research and Application, Osaka University Hospital, Suita, Japan; 7Department of Health Promotion, National Institute of Public Health, Wako, Japan; 8Japan Ophthalmologist Association, Tokyo, JapanCorrespondence: Masakazu Yamada Department of OphthalmologyKyorin University School of Medicine, Mitaka, JapanEmail [email protected]: The efficacy of vision screening for adults has not been well established. The present study aimed to investigate the prevalence of vision-threatening ocular diseases, including glaucoma, among subjects who participated in specific health checkups in Japan.Methods: This cross-sectional study included 1360 individuals who underwent comprehensive ophthalmic examinations at 16 ophthalmology clinics located in three municipalities. We surveyed the study participants using a questionnaire. The participants also underwent visual acuity and refraction tests, intraocular pressure tests, slit-lamp microscopy, fundus examinations, fundus photography, optical coherence tomography, and static perimetry.Results: The mean age of the subjects was 63.7 ± 8.7 years (range, 40– 74 years). Among the 1360 participants, 168 (12.4%) were diagnosed with glaucoma and 33 (2.4%) with preperimetric glaucoma. Cataracts were seen in 741 participants (54.5%), and 77 (5.7%) were diagnosed with clinically significant cataracts. Retinal diseases included macular degeneration (1.2%), diabetic retinopathy (1.0%), chorioretinal atrophy (0.5%), macular epiretinal membrane (2.9%), branch retinal vein occlusion (0.7%), and others (2.0%). Regarding the type of glaucoma, 93.5% of participants with glaucoma were diagnosed with open-angle glaucoma in a broad sense (81.0% with normal-tension glaucoma and 12.5% with primary open-angle glaucoma). Multivariate analysis showed that male sex, age, systemic comorbidities, and myopia were significant risk factors for open-angle glaucoma.Conclusion: Many adults with ocular diseases were screened by ophthalmic checkups. The addition of simultaneous ophthalmic checkups to specific health checkups could be an effective measure for the prevention of visual impairment in the older population.Keywords: cataract, glaucoma, ocular disease, prevalence, vision screening