Philippine Journal of Ophthalmology (Dec 2019)

Comparison of the Clinical Profile of Patients with Glaucoma Between Private and Government Clinics in the Philippines

  • Edgar Felipe U. Leuenberger, MD, DPBO,
  • Marie Joan Therese D. Balgos, MD, DPBO,
  • Shalam Siao-Mariano, MD, DPBO,
  • Denise Polly Chao-Po, MD, DPBO,
  • Irene R. Felarca, MD, DPBO,
  • Rainier Victor A. Covar, MD, DPBO,
  • Nilo Vincent FlorCruz, MD, DPBO,
  • John Mark S. De Leon, MD, DPBO,
  • Jose Ma. D. Martinez, MD, DPBO,
  • Joseph Anthony J. Tumbocon, MD, DPBO,
  • Maria Imelda Yap-Veloso, MD, DPBO,
  • Robert Edward T. Ang, MD, DPBO,
  • James Paul S. Gomez, MD, DPBO,
  • Noel D. Atienza, MD, DPBO

Journal volume & issue
Vol. 44, no. 2
pp. 45 – 53

Abstract

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Objective: To describe the demographic and clinical characteristics of patients with glaucoma managed at private and government institutions in the Philippines between 2009 and 2014. Methods: A research team from two private and two government institutions in the Philippines reviewed the case records of 1246 patients seen who met the following criteria: intraocular pressure of >21 mmHg, optic nerve and nerve fiber layer abnormalities, and visual field defects. For bilateral cases, we selected the eye with worse glaucoma parameters. Results: There were 600 and 646 patients in the private and government groups (mean age at presentation, 60.51 and 55.88 years), respectively, with the majority being Filipino (91%). Patients with visual acuity (VA) of 20/20 to 20/40 were more frequently observed in private centers (58.7% vs. 41.3%), while a VA worse than counting fingers was more frequently observed in government centers (66.1% vs. 33.9%). Within-group analysis showed that primary angle-closure glaucoma was the most frequent glaucoma subtype in both private (27.3%) and government institutions (37.8%). In between-group analysis showed the following to be more common in private than government centers: primary open-angle glaucoma (61.3% vs. 38.7%), normal-tension glaucoma (63.9% vs. 36.1%), ocular hypertension (92.3% vs. 7.7%), and glaucoma suspects (80.4% vs. 19.6%) while government institutions registered a larger number of primary angle-closure glaucoma (59.8% vs. 40.2%) and secondary glaucoma (70.3% vs. 29.7%) cases. Medical treatment using a single drug and multiple drugs was employed for 245 (23%) and 825 (77%) patients, respectively. Within-group analysis showed that laser iridotomy and trabeculectomy were the most commonly performed laser and surgical procedures in both institution types. Conclusion: There is a contrasting profile of glaucoma between clinical institutions in the Philippines with openangle glaucoma being more predominant in private centers while closed-angle glaucoma and secondary glaucoma being more frequent in government centers. Our findings may provide important preliminary information that can aid future health studies or training programs.

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