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Prevalence of glaucoma in rural Myanmar: the Meiktila Eye Study

¹ Department of Ophthalmology and Visual Sciences, South Australian Institute of Ophthalmology, Adelaide University, Adelaide, South Australia, Australia
² Meiktila Eye Hospital and Trachoma Control and Prevention Programme, Meiktila, Myanmar
³ Yangon Eye Hospital, Yangon, Myanmar

Correspondence to:
Correspondence to:
Professor R J Casson
Associate Professor, Department of Ophthalmology and Visual Sciences, South Australian Institute of Ophthalmology, Adelaide University, Adelaide 5000, South Australia, Australia; robert.casson{at}adelaide.edu.au

ABSTRACT
Aim: To determine the prevalence of glaucoma in the Meiktila district of central, rural Myanmar.

Methods: A cross-sectional, population-based survey of inhabitants 40 years of age from villages in Meiktila district, Myanmar, was performed; 2481 eligible participants were identified and 2076 participated in the study. The ophthalmic examination included Snellen visual acuity, slit-lamp examination, tonometry, gonioscopy, dilated stereoscopic fundus examination and full-threshold perimetry. Glaucoma was classified into clinical subtypes and categorised into three levels according to diagnostic evidence.

Results: Glaucoma was diagnosed in 1997 (80.5%) participants. The prevalence of glaucoma of any category in at least one eye was 4.9% (95% CI 4.1 to 5.7; n = 101). The overall prevalence of primary angle-closure glaucoma (PACG) was 2.5% (95% CI 1.5 to 3.5) and of primary open-angle glaucoma (POAG) was 2.0% (95% CI 0.9 to 3.1). PACG accounted for 84% of all blindness due to glaucoma, with the majority due to acute angle-closure glaucoma (AACG).

Conclusion: The prevalence of glaucoma in the population aged 40 years in rural, central Myanmar was 4.9%. The ratio of PACG to POAG was approximately 1.25:1. PACG has a high visual morbidity and AACG is visually devastating in this community. Screening programmes should be directed at PACG, and further study of the underlying mechanisms of PACG is needed in this population.

Abbreviations: AACG, acute angle-closure glaucoma; CDR, cup/disc ratio; FDT, frequency doubling technology; IOP, intraocular pressure; ISGEO, International Society for Geographic and Epidemiological Ophthalmology; MES, Meiktila Eye Study; MOH, Ministry of Health; PACG, primary angle-closure glaucoma; POAG, primary open-angle glaucoma; TM, trabecular meshwork; VA, visual acuity; WHO, World Health Organization

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