Skip to main content
SpringerLink
Log in

Bewusstsein für eine Glaukomerkrankung in der Bevölkerung

Awareness for glaucoma in the general population

  • Leitthema
  • Published:
Die Ophthalmologie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Glaukomerkrankungen sind keine seltene Entität. Weil jedoch kaum Symptome auftreten und die Gesichtsfelddefekte häufig erst spät bemerkt werden, bleibt ein großer Anteil der Glaukomerkrankungen unerkannt. Ziel der Arbeit war es, den Anteil nicht diagnostizierter Glaukomerkrankungen in deutschen populationsbasierten Studien zu ermitteln und sie in den Literaturkontext einzuordnen.

Material und Methoden

Im Rahmen der Gutenberg-Gesundheitsstudie (GHS) und der Altersbezogenen Untersuchungen zur Gesundheit der Universität Regensburg (AugUR) wurden die Glaukomprävalenz anhand von Gesichtsfelduntersuchungen und Fundusfarbfotos mithilfe der Kriterien der International Society of Geographical and Epidemiological Ophthalmology (ISGEO) sowie die selbstberichteten Glaukomerkrankungen erhoben, und der Anteil nicht diagnostizierter Glaukome wurde bestimmt.

Ergebnisse

In der GHS betrug der Anteil nicht diagnostizierter Glaukome 55 %, in der AugUR-Studie 53 %. Die Ergebnisse passen zu Daten aus anderen Ländern, in denen der Anteil nicht erkannter Glaukome zwischen 33 % und 78 % liegt. In GHS und AugUR war der Anteil nicht diagnostizierter Glaukome in jüngeren Altersgruppen und bei Frauen höher.

Diskussion

Etwa jede zweite Glaukomerkrankung in Deutschland ist unentdeckt. Da die Symptome oft unspezifisch sind oder lange ausbleiben, besteht durch das fehlende Bewusstsein für Glaukomerkrankungen die Gefahr für einen fortschreitenden Gesichtsfelddefekt und Erblindung. Studien zeigen, dass ein systematisches Screening dieses Risiko halbieren kann.

Abstract

Background

Glaucoma is not a rare entity but because very few symptoms occur and visual field defects are frequently first recognized at a late stage, a large proportion of glaucoma diseases remain undetected. The aim of this study was to identify the proportion of undiagnosed glaucoma in German population-based cohort studies and to contextualize them in the context of the literature.

Material and methods

The prevalence of glaucoma in the Gutenberg Health Study (GHS) and the age-related investigations on health of the University of Regensburg (AugUR) was evaluated based on visual field examinations and optic disc color photography according to the ISGEO criteria. Furthermore, the self-reported glaucoma diagnoses were collected and the proportion of undiagnosed glaucoma was determined.

Results

The proportion of undiagnosed glaucoma was 55% in the GHS, and 53% in the AugUR study. The results correlate with results from previous studies from other countries in which the proportion of unrecognized glaucoma ranged from 33% to 78%. In the GHS and the AugUR study the proportion of undiagnosed glaucoma was higher in younger age groups and in women.

Discussion

Roughly every second case of glaucoma is undetected. As the symptoms are often nonspecific or take a long time to appear, there is a risk of advanced glaucomatous visual field defects or blindness due to a lack of glaucoma awareness. Studies have shown that a systematic screening can halve this risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121(11):2081–2090

    PubMed  Google Scholar 

  2. Kapetanakis VV, Chan MP, Foster PJ, Cook DG, Owen CG, Rudnicka AR (2016) Global variations and time trends in the prevalence of primary open angle glaucoma (POAG): a systematic review and meta-analysis. Br J Ophthalmol 100(1):86–93

    PubMed  Google Scholar 

  3. GBD 2019 Blindness and Vision Impairment Collaborators (2021) Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the right to sight: an analysis for the global burden of disease study. Lancet Glob Health 9(2):e144–e60

    Google Scholar 

  4. No authors listed (2000) The advanced glaucoma intervention study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration.the AGIS investigators. Am J Ophthalmol 130(4):429–440

    Google Scholar 

  5. No authors listed (1998) The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Collaborative normal-tension glaucoma study group. Am J Ophthalmol 126(4):498–505

    Google Scholar 

  6. Lichter PR, Musch DC, Gillespie BW, Guire KE, Janz NK, Wren PA et al (2001) Interim clinical outcomes in the collaborative initial glaucoma treatment study comparing initial treatment randomized to medications or surgery. Ophthalmology 108(11):1943–1953

    CAS  PubMed  Google Scholar 

  7. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M (2002) Reduction of intraocular pressure and glaucoma progression: results from the early manifest glaucoma trial. Arch Ophthalmol 120(10):1268–1279

    PubMed  Google Scholar 

  8. Shah YS, Cheng M, Mihailovic A, Fenwick E, Lamoureux E, Ramulu PY (2022) Patient-reported symptoms demonstrating an association with severity of visual field damage in glaucoma. Ophthalmology 129(4):388–396

    PubMed  Google Scholar 

  9. Crabb DP, Smith ND, Glen FC, Burton R, Garway-Heath DF (2013) How does glaucoma look?: patient perception of visual field loss. Ophthalmology 120(6):1120–1126

    PubMed  Google Scholar 

  10. Fatehi N, Nowroozizadeh S, Henry S, Coleman AL, Caprioli J, Nouri-Mahdavi K (2017) Association of structural and functional measures with contrast sensitivity in glaucoma. Am J Ophthalmol 178:129–139

    PubMed Central  PubMed  Google Scholar 

  11. Amanullah S, Okudolo J, Rahmatnejad K, Lin SC, Wizov SS, Manzi Muhire RS et al (2017) The relationship between contrast sensitivity and retinal nerve fiber layer thickness in patients with glaucoma. Graefes Arch Clin Exp Ophthalmol 255(12):2415–2422

    PubMed  Google Scholar 

  12. Owidzka M, Laudanska-Olszewska I, Omulecki W (2016) Contrast sensitivity assessment in primary open angle glaucoma and ocular hypertension. Klin Oczna 118(1):7–10

    PubMed  Google Scholar 

  13. Bierings R, de Boer MH, Jansonius NM (2018) Visual performance as a function of luminance in glaucoma: the de Vries-Rose, weber’s, and Ferry-Porter’s law. Invest Ophthalmol Vis Sci 59(8):3416–3423

    PubMed  Google Scholar 

  14. Ouchi J, Kunikata H, Omodaka K, Sato H, Sato H, Ito A et al (2019) Color visual acuity in preperimetric glaucoma and open-angle glaucoma. PLoS ONE 14(4):e215290

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Mansouri K, Orgül S, Meier-Gibbons F, Mermoud A (2006) Awareness about glaucoma and related eye health attitudes in Switzerland: a survey of the general public. Ophthalmologica 220(2):101–108

    PubMed  Google Scholar 

  16. Pfeiffer N, Krieglstein GK, Wellek S (2002) Knowledge about glaucoma in the unselected population: a German survey. J Glaucoma 11(5):458–463

    PubMed  Google Scholar 

  17. Mitchell P, Smith W, Attebo K, Healey PR (1996) Prevalence of open-angle glaucoma in Australia. The Blue Mountains Eye Study. Ophthalmology 103(10):1661–1669

    CAS  PubMed  Google Scholar 

  18. Dielemans I, Vingerling JR, Wolfs RC, Hofman A, Grobbee DE, de Jong PT (1994) The prevalence of primary open-angle glaucoma in a population-based study in The Netherlands. The Rotterdam Study. Ophthalmology 101(11):1851–1855

    CAS  PubMed  Google Scholar 

  19. McCann P, Hogg R, Wright DM, Pose-Bazarra S, Chakravarthy U, Peto T et al (2020) Glaucoma in the Northern Ireland cohort for the longitudinal study of ageing (NICOLA): cohort profile, prevalence, awareness and associations. Br J Ophthalmol 104(11):1492–1499

    PubMed  Google Scholar 

  20. Shaikh Y, Yu F, Coleman AL (2014) Burden of undetected and untreated glaucoma in the United States. Am J Ophthalmol 158(6):1121–1129.e1

    PubMed  Google Scholar 

  21. Chua J, Baskaran M, Ong PG, Zheng Y, Wong TY, Aung T et al (2015) Prevalence, risk factors, and visual features of undiagnosed glaucoma: the Singapore epidemiology of eye diseases study. JAMA Ophthalmol 133(8):938–946

    PubMed  Google Scholar 

  22. Topouzis F, Coleman AL, Harris A, Koskosas A, Founti P, Gong G et al (2008) Factors associated with undiagnosed open-angle glaucoma: the Thessaloniki eye study. Am J Ophthalmol 145(2):327–335

    PubMed  Google Scholar 

  23. Chan MPY, Broadway DC, Khawaja AP, Yip JLY, Garway-Heath DF, Burr JM et al (2017) Glaucoma and intraocular pressure in EPIC-Norfolk eye study: cross sectional study. BMJ 358:j3889

    PubMed Central  PubMed  Google Scholar 

  24. Foster PJ, Buhrmann R, Quigley HA, Johnson GJ (2002) The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 86(2):238–242

    PubMed Central  PubMed  Google Scholar 

  25. Gupta P, Zhao D, Guallar E, Ko F, Boland MV, Friedman DS (2016) Prevalence of glaucoma in the United States: the 2005–2008 national health and nutrition examination survey. Invest Ophthalmol Vis Sci 57(6):2905–2913

    PubMed  Google Scholar 

  26. Eke T, Reddy MA, Karwatowski WS (1999) Glaucoma awareness and screening uptake in relatives of people with glaucoma. Eye (Lond) 13(5):647–649

    PubMed  Google Scholar 

  27. Wolfs RCW, Borger PH, Ramrattan RS, Klaver CCW, Hulsman CAA, Hofman A et al (2000) Changing views on open-angle glaucoma: definitions and prevalences—the Rotterdam study. Investigative ophthalmology & visual. Science 41(11):3309–3321

    CAS  Google Scholar 

  28. Höhn R, Kottler U, Peto T, Blettner M, Münzel T, Blankenberg S et al (2015) The ophthalmic branch of the Gutenberg health study: study design, cohort profile and self-reported diseases. PLoS ONE 10(3):e120476

    PubMed Central  PubMed  Google Scholar 

  29. Stark K, Olden M, Brandl C, Dietl A, Zimmermann ME, Schelter SC et al (2015) The German AugUR study: study protocol of a prospective study to investigate chronic diseases in the elderly. BMC Geriatr 15:130

    PubMed Central  PubMed  Google Scholar 

  30. Steinkirchner AB, Zimmermann ME, Donhauser FJ, Dietl A, Brandl C, Koller M et al (2022) Self-report of chronic diseases in old-aged individuals: extent of agreement with general practitioner medical records in the German AugUR study. J Epidemiol Community Health 76(11):931–938

    PubMed  Google Scholar 

  31. Brandl C, Zimmermann ME, Günther F, Barth T, Olden M, Schelter SC et al (2018) On the impact of different approaches to classify age-related macular degeneration: results from the German AugUR study. Sci Rep 8(1):8675

    PubMed Central  PubMed  Google Scholar 

  32. Deutsche Ophthalmolgische Gesellschaft e. V. (DOG) (2020) S2e Leitlinie: Bewertung von Risikofaktoren für das Auftreten des Offenwinkelglaukoms

    Google Scholar 

  33. Aspberg J, Heijl A, Bengtsson B (2021) Screening for open-angle glaucoma and its effect on blindness. Am J Ophthalmol 228:106–116

    PubMed  Google Scholar 

  34. Aspberg J, Heijl A, Bengtsson B (2023) Estimating the length of the preclinical detectable phase for open-angle glaucoma. JAMA Ophthalmol 141(1):48–54

    PubMed  Google Scholar 

  35. Mokhles P, Schouten JS, Beckers HJ, Azuara-Blanco A, Tuulonen A, Webers CA (2016) A systematic review of end-of-life visual impairment in open-angle glaucoma: an epidemiological autopsy. J Glaucoma 25(7):623–628

    PubMed  Google Scholar 

  36. Chuvarayan Y, Finger RP, Köberlein-Neu J (2020) Economic burden of blindness and visual impairment in Germany from a societal perspective: a cost-of-illness study. Eur J Health Econ 21(1):115–127

    PubMed  Google Scholar 

  37. Hamid S, Desai P, Hysi P, Burr JM, Khawaja AP (2022) Population screening for glaucoma in UK: current recommendations and future directions. Eye (Lond) 36(3):504–509

    PubMed  Google Scholar 

  38. Weih LM, Nanjan M, McCarty CA, Taylor HR (2001) Prevalence and predictors of open-angle glaucoma: results from the visual impairment project. Ophthalmology 108(11):1966–1972

    CAS  PubMed  Google Scholar 

  39. Tielsch JM, Katz J, Sommer A, Quigley HA, Javitt JC (1994) Family history and risk of primary open angle glaucoma. The Baltimore eye survey. Arch Ophthalmol 112(1):69–73

    CAS  PubMed  Google Scholar 

  40. Craig JE, Han X, Qassim A, Hassall M, Cooke Bailey JN, Kinzy TG et al (2020) Multitrait analysis of glaucoma identifies new risk loci and enables polygenic prediction of disease susceptibility and progression. Nat Genet 52(2):160–166

    CAS  PubMed Central  PubMed  Google Scholar 

  41. Hemelings R, Elen B, Barbosa-Breda J, Lemmens S, Meire M, Pourjavan S et al (2020) Accurate prediction of glaucoma from colour fundus images with a convolutional neural network that relies on active and transfer learning. Acta Ophthalmol 98(1):e94–e100

    PubMed  Google Scholar 

  42. Hemelings R, Elen B, Schuster AK, Blaschko MB, Barbosa-Breda J, Hujanen P et al (2023) A generalizable deep learning regression model for automated glaucoma screening from fundus images. NPJ Digit Med 6(1):112

    PubMed Central  PubMed  Google Scholar 

  43. Wang X, Chen H, Ran AR, Luo L, Chan PP, Tham CC et al (2020) Towards multi-center glaucoma OCT image screening with semi-supervised joint structure and function multi-task learning. Med Image Anal 63:101695

    PubMed  Google Scholar 

  44. Brusini P (2018) OCT glaucoma staging system: a new method for retinal nerve fiber layer damage classification using spectral-domain OCT. Eye (Lond) 32(1):113–119

    CAS  PubMed  Google Scholar 

  45. Hemelings R, Elen B, Barbosa-Breda J, Bellon E, Blaschko MB, De Boever P et al (2022) Pointwise visual field estimation from optical coherence tomography in glaucoma using deep learning. Transl Vis Sci Technol 11(8):22

    PubMed Central  PubMed  Google Scholar 

  46. Jampel HD, Schwartz GF, Robin AL, Abrams DA, Johnson E, Miller RB (2003) Patient preferences for eye drop characteristics: a willingness-to-pay analysis. Arch Ophthalmol 121(4):540–546

    PubMed  Google Scholar 

  47. Tsai JC, McClure CA, Ramos SE, Schlundt DG, Pichert JW (2003) Compliance barriers in glaucoma: a systematic classification. J Glaucoma 12(5):393–398

    PubMed  Google Scholar 

  48. Schenker H, Maloney S, Liss C, Gormley G, Hartenbaum D (1999) Patient preference, efficacy, and compliance with timolol maleate ophthalmic gel-forming solution versus timolol maleate ophthalmic solution in patients with ocular hypertension or open-angle glaucoma. Clin Ther 21(1):138–147

    CAS  PubMed  Google Scholar 

  49. Kass MA, Gordon M, Morley RE Jr., Meltzer DW, Goldberg JJ (1987) Compliance with topical timolol treatment. Am J Ophthalmol 103(2):188–193

    CAS  PubMed  Google Scholar 

  50. Konstas AGP, Maskaleris G, Gratsonidis S, Sardelli C (2000) Compliance and viewpoint of glaucoma patients in Greece. Eye (Lond) 14(5):752–756

    PubMed  Google Scholar 

  51. Rotchford AP, Murphy KM (1998) Compliance with timolol treatment in glaucoma. Eye (Lond) 12(2):234–236

    PubMed  Google Scholar 

  52. Gurwitz JH, Yeomans SM, Glynn RJ, Lewis BE, Levin R, Avorn J (1998) Patient noncompliance in the managed care setting. The case of medical therapy for glaucoma. Med Care 36(3):357–369

    CAS  PubMed  Google Scholar 

  53. Patel SC, Spaeth GL (1995) Compliance in patients prescribed eyedrops for glaucoma. Ophthalmic Surg 26(3):233–236

    CAS  PubMed  Google Scholar 

  54. Gurwitz JH, Glynn RJ, Monane M, Everitt DE, Gilden D, Smith N et al (1993) Treatment for glaucoma: adherence by the elderly. Am J Public Health 83(5):711–716

    CAS  PubMed Central  PubMed  Google Scholar 

  55. Frech S, Guthoff RF, Gamael A, Helbig C, Diener A, Ritzke M et al (2021) Patterns and facilitators for the promotion of glaucoma medication adherence—a qualitative study. Healthcare 9(4):426

    PubMed Central  PubMed  Google Scholar 

  56. Frech S, Kreft D, Guthoff RF, Doblhammer G (2018) Pharmacoepidemiological assessment of adherence and influencing co-factors among primary open-angle glaucoma patients—an observational cohort study. PLoS ONE 13(1):e191185

    PubMed Central  PubMed  Google Scholar 

  57. Schwartz GF, Quigley HA (2008) Adherence and persistence with glaucoma therapy. Surv Ophthalmol 53(6):S57–S68

    PubMed  Google Scholar 

  58. Newman-Casey PA, Weizer JS, Heisler M, Lee PP, Stein JD (2013) Systematic review of educational interventions to improve glaucoma medication adherence. Semin Ophthalmol 28(3):191–201

    PubMed Central  PubMed  Google Scholar 

  59. Ha A, Jang M, Shim SR, Kim CY, Chang IB, Kim YK (2022) Interventions for glaucoma medication adherence improvement: a network meta-analysis of randomized controlled trials. Ophthalmology 129(11):1294–1304

    PubMed  Google Scholar 

  60. Norell SE (1979) Improving medication compliance: a randomised clinical trial. Br Med J 2(6197):1031–1033

    CAS  PubMed Central  PubMed  Google Scholar 

  61. Okeke CO, Quigley HA, Jampel HD, Ying GS, Plyler RJ, Jiang Y et al (2009) Interventions improve poor adherence with once daily glaucoma medications in electronically monitored patients. Ophthalmology 116(12):2286–2293

    PubMed  Google Scholar 

  62. Cook PF, Bremer RW, Ayala AJ, Kahook MY (2010) Feasibility of motivational interviewing delivered by a glaucoma educator to improve medication adherence. Clin Ophthalmol 4:1091–1101

    PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Augenklinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland

    Julia V. Stingl, Esther M. Hoffmann, Norbert Pfeiffer & Alexander K. Schuster

  2. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland

    R. Greslechner, Caroline Brandl & Iris M. Heid

  3. Lehrstuhl für Genetische Epidemiologie, Universität Regensburg, Regensburg, Deutschland

    Caroline Brandl

Authors
  1. Julia V. Stingl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Greslechner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Caroline Brandl
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Iris M. Heid
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Esther M. Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Norbert Pfeiffer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alexander K. Schuster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julia V. Stingl.

Ethics declarations

Interessenkonflikt

J.V. Stingl, R. Greslechner, C. Brandl, I.M. Heid, E.M. Hoffmann, N. Pfeiffer und A.K. Schuster geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Hinweis des Verlags

Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stingl, J.V., Greslechner, R., Brandl, C. et al. Bewusstsein für eine Glaukomerkrankung in der Bevölkerung. Ophthalmologie 120, 1088–1097 (2023). https://doi.org/10.1007/s00347-023-01943-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00347-023-01943-0

Schlüsselwörter

Keywords

Search

Navigation