Background: The glaucoma-specific blindness prevalence in Nigeria (0.7 %, 95 % CI 0.6ââ?¬â??0.9 %) among those aged\nââ?°Â¥40 years is one of the highest ever reported. This study determined the risk factors for open-angle glaucoma\n(OAG) in adults examined in the Nigeria National Blindness and Visual Impairment Survey.\nMethods: A nationally representative sample of 13,591 people aged ââ?°Â¥40 years in 305 clusters in Nigeria were examined\n(response rate 90.4 %) between January 2005 to June 2007. Everyone had logMAR visual acuity measurement, Frequency\nDoubling Technology (FDT) visual field testing, autorefraction, A-scan biometry and optic disc assessment. Full ocular\nexamination (n = 6397), included Goldmann applanation tonometry. Values for defining glaucoma using International\nSociety of Geographical and Epidemiological Ophthalmology criteria were derived from the study population.\nDisc images were graded by Moorfields Eye Hospital Reading Centre. Socio-demographic factors (age, gender,\nethnicity, literacy and place of residence), ocular parameters (intraocular pressure [IOP], axial length and mean\nocular perfusion pressure [MOPP]) and systemic parameters (blood pressure, blood glucose and body mass index\n[BMI]) were assessed for association with OAG.\nResults: Thirteen thousand eighty-one (96 %) of 13,591 participants had vertical cup:disc ratio measured in at least one\neye. 682 eyes of 462 participants were classified as OAG, with 12,738 controls. In univariate analyses the following were\nassociated with OAG: increasing age, male gender, Igbo and Yoruba ethnic groups, illiteracy, longer axial length, higher\nIOP, lower MOPP, greater severity of hypertension and low BMI (underweight). In multivariate analysis, increasing age\n(odds ratio [OR] 1.04, 95 % CI 1.03ââ?¬â??1.05), higher IOP (OR 1.22, 95 % CI 1.18ââ?¬â??1.25) and Igbo ethnicity (OR 1.73,\n95 % CI 1.18ââ?¬â??2.56) were independent risk factors for OAG.\nConclusion: Case detection strategies for OAG should be improved for those aged ââ?°Â¥40 years and for ethnic groups\nmost at risk as a public health intervention.
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