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The 12-year Incidence of Glaucoma and Glaucoma-related Visual Field Loss in Italy: The Ponza Eye Study

Cedrone, Claudio PhD*; Mancino, Raffaele MD*; Ricci, Federico MD*; Cerulli, Angelica MD*; Culasso, Franco PhD; Nucci, Carlo MD, PhD*

doi: 10.1097/IJG.0b013e3182027796
Original Studies

Purpose To assess the 12-year incidence of glaucoma and glaucoma-related visual field loss in a population-based cohort study.

Patients In 2000, we reexamined 411 of the 581 survivors from the original Ponza eye study conducted in 1988.

Methods Primary open-angle (POAG), primary angle-closure (PACG), and secondary [pseudoexfoliative (PEX)] glaucoma were diagnosed according to the 3-tiered system of evidence developed by the International Society of Geographical and Epidemiological Ophthalmology. Severity of glaucoma was classified according to the Bascom-Palmer system. Visual loss was defined according to World Health Organization guidelines. Relative risk ratios were calculated for several variables.

Results The 12-year incidence of definite POAG was 3.8% (95% confidence intervals (CI), 2.3-6.2), that is, an average annual rate of 0.32%. Corresponding rates for PACG and PEX glaucoma were 0.5% (95% CI, 0.1-1.8) and 0.8% (95% CI, 0.3-2.2), respectively. Half the incident glaucoma cases (45%) had not been diagnosed earlier. Fifty-five percent of the incident POAG eyes had Bascom-Palmer stage 1 or 2 disease and 40% of the incident PACG or PEX glaucoma eyes had stage 3 or 4 disease. Seven of 20 incident glaucoma cases presented with monocular or binocular visual loss because of advanced visual field loss. Significant risk factors for POAG included high myopia (>6.0 D), intraocular pressure ≥22 mm Hg, and glaucoma family history.

Conclusion The average annual incidence of definite POAG in Ponzas lower than that reported in persons of African ancestry and higher than that observed in certain other white populations.

*Department of Biopathology and Diagnostic Imaging, University of Rome “Tor Vergata”

Department of Experimental Medicine, University of Rome “La Sapienza,” Rome, Italy

Supported in part by a grant from the Italian Ministry of Instruction, University and Research, 1998 to 2000, project no. 9806216964.

Disclosure: The authors declare no conflict of interest.

Reprints: Claudio Cedrone, PhD, Cattedra di Oftalmologia, Dipartimento di Biopatologia e Diagnostica per Immagini, Università degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Roma, Italy (e-mail:

Received February 5, 2010

Accepted October 11, 2010

© 2012 Lippincott Williams & Wilkins, Inc.