Detection of Glaucoma and Other Vision-Threatening Ocular Diseases in the Population Recruited at Specific Health Checkups in Japan

Clin Epidemiol. 2020 Dec 17:12:1381-1388. doi: 10.2147/CLEP.S273016. eCollection 2020.

Abstract

Background: 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.

Grants and funding

This study was supported by a grant (19FA1010) from the Ministry of Health, Labor and Welfare, Japan.