Prevalência de glaucoma identificada em campanha de detecção em São Paulo

Purpose: To evaluate the prevalence of glaucoma and associated risk factors diagnosed during a glaucoma screening program. Methods: A screening program for detection of glaucoma was carried out in a major public hospital in São Paulo for one week in August 1997. During this period, 1438 patients with age between 40 and 87 years (average 58.24 ± 10.88) were evaluated regarding glaucoma. The inclusion criterion was age of at least 40 years. The screening examination consisted of a standardized questionnaire, intraocular pressure (IOP) and optic nerve assessment by direct ophthalmoscopy. Patients with: increased intraocular pressure and/or suspicious optic discs were referred to further tests (complete ocular examination, automated visual field test and optic disc stereophotograph). The clinical chart of all patients were reviewed by two experienced observers, using predefined criteria. Results: A hundred and five patients (7.3%) were identified having glaucoma, 91 of these (86.7%) with primary open angle glaucoma (POAG). Fifty six of the POAG patients (61.5%) had screening IOP below 22 mmHg, and only 7 of these were using ocular hypotensive medications. Other 65 patients (4.5%) had suspicious optic disc appearance, without definitive disc or field damage. 49 patients (3.4%) were classified as ocular hypertensives (intraocular pressure over 21 mmHg with normal disc). Patients with POAG were significantly older than subjects without glaucoma. As expected, the mean IOP was significantly higher in POAG patients than in normal. No significant difference was observed between subjects with diabetes, systemic hypertension, coronary disease, migraine and family history of glaucoma and POAG patients and normals. Conclusions: A high prevalence of glaucoma was observed during this screening program. The majority of newly diagnosed cases had intraocular pressure below 22 mmHg. Older age and elevated intraocular pressure was associated with the presence of primary open angle glaucoma.