TITLE:
Epidemiological, Clinical, Therapeutic and Evolutive Profile of Primary Open-Angle Glaucoma in a Cameroonian Population
AUTHORS:
Christelle Domngang, Fabiola Makamwe Tagne, Leonard Tedong, Chantal Ngoune Nanfack, Caroline Mvilongo, Giles Kagmeni
KEYWORDS:
Primary Open-Angle Glaucoma, Medical Treatment, Intraocular Pressure, Target Intraocular Pressure
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.14 No.2,
March
21,
2024
ABSTRACT: Background: Sub-Saharan Africa has the highest prevalence of primary open-angle
glaucoma (POAG), at 4.2%. The efficacy of medical treatment has been
demonstrated and remains one of the treatments of choice for POAG. However, in
sub-Saharan Africa, its effectiveness has many challenges, due to multiple
factors, including cost and access to care. Thus, the present study aimed to
determine the
epidemiological, clinical, therapeutic and evolutive profile of primary
open-angle glaucoma patients. Methodology: A descriptive cross-sectional
study was carried out in two hospitals in western Cameroon. Epidemiological,
clinical, therapeutic, and evolutionary data on intraocular pressure at one
year after medical treatment were analyzed. SPSS version 23 software was used
for statistical analysis, with a significant p-value set at 5%. Results: A total of 201 patients with POAG were included in the study. The population
comprised 100 men and 101 women, with a mean age of 54 ± 12 years. At diagnosis,
the mean intraocular pressure was 23.9 ± 8.70
mmHg for the right eye and 25.5 ± 9.57 mmHg for the left
eye. The mean cup/disc ratio was 0.64 ± 0.2
[0.2-1] and 0.67 ± 0.19 [02-1] in the right and left
eyes, respectively. Monotherapy was the most prescribed treatment [59.2%].
After one year of treatment, intraocular pressure was reduced by 15.5% with
beta-blockers, 23.66% with prostaglandins, 19.11% with carbonic anhydrase
inhibitors, 35, 92% with beta-blockers and carbonic anhydrase inhibitors,
25.92% with beta-blockers and prostaglandins, 48.03% with carbonic anhydrase
inhibitors and prostaglandin agonists, and 38.77% with triple therapy. Taking
glaucoma severity into account, a significant reduction in intraocular pressure
at one year was observed in all participants [p 0.05].
However, the target pressure was obtained in 47%, 20% and 14% of eyes suffering
of mild, moderate, and severe grade of POAG respectively. Conclusion: In the present study, there was a significant reduction in intraocular pressure after
one year of medical treatment. However, the reduction in intraocular pressure
does not allow the target pressure to be reached in severe forms. Thus,
alternatives to the medical treatment of POAG should be discussed early in the
present context.