Product information and disease description Place of product in therapy Disease description

Definition and etiology

9 evidence topics · 6 sources

Definition: primary open-angle glaucoma

“Primary open-angle glaucoma (POAG) in adults is a chronic, progressive optic neuropathy in which there is a characteristic acquired atrophy of the optic nerve and irreversible loss of retinal ganglion cells and their axons. In POAG, the anterior chamber is open by gonioscopy and secondary causes of IOP elevation are absent. Primary open-angle glaucoma is a potentially blinding eye disease, but early diagnosis and treatment can generally prevent visual disability.” (opens the source at this quote in a new tab)
“Primary open-angle glaucoma is a chronic ocular disease process that is progressive, generally bilateral, but often asymmetric.” (opens the source at this quote in a new tab)

“The glaucomas are a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease.” (opens the source at this quote in a new tab)

Definition: ocular hypertension and primary open-angle glaucoma suspect

“A primary open-angle glaucoma (POAG) suspect is an individual with clinical findings and/or a constellation of risk factors that indicate an increased likelihood of developing POAG.” (opens the source at this quote in a new tab)
“A diagnosis of POAG suspect is established by the presence of an open angle and at least one of the following conditions: a consistently elevated IOP, also known as ocular hypertension, or a suspicious optic nerve, circumpapillary RNFL/macular ganglion cell layer on optical coherence tomography, or visual field.” (opens the source at this quote in a new tab)

Classification: open-angle and angle-closure glaucoma

“Glaucomas can be classified into 2 broad categories: open-angle glaucoma and angle-closure glaucoma. In the United States, more than 80% of cases are open-angle glaucoma; however, angle-closure glaucoma is responsible for a disproportionate number of patients with severe vision loss.” (opens the source at this quote in a new tab)

Etiology and risk factors

“Glaucoma is a chronic progressive optic neuropathy, characterized by damage to the optic nerve and retinal nerve fiber layer, that can lead to permanent loss of peripheral or central vision. Intraocular pressure is the only known modifiable risk factor. Other important risk factors include older age, nonwhite race, and a family history of glaucoma. Several systemic medical conditions and medications including corticosteroids, anticholinergics, certain antidepressants, and topiramate may predispose patients to glaucoma.” (opens the source at this quote in a new tab)

“Risk factors for primary open-angle glaucoma-the most common form of glaucoma-include older age, elevated intraocular pressure, sub-Saharan African ethnic origin, positive family history, and high myopia.” (opens the source at this quote in a new tab)

Etiology: genetic contribution

“Despite promising results, susceptibility genes that have been identified to date for primary open-angle glaucoma only have a modest effect size in explaining glaucoma risk.” (opens the source at this quote in a new tab)

Baseline predictors of conversion from ocular hypertension to primary open-angle glaucoma

“In multivariate analyses, baseline factors that predicted the development of POAG included older age, larger vertical or horizontal cup-disc ratio, higher intraocular pressure, greater pattern standard deviation, and thinner central corneal measurement.” (opens the source at this quote in a new tab)
“Central corneal thickness was found to be a powerful predictor for the development of POAG.” (opens the source at this quote in a new tab)

Magnitude of risk by age, ancestry, and refractive error

“In a meta-analysis of population-based studies, the odds ratio for primary open-angle glaucoma was 1·73 (95% CI 1·63–1·82) for each decade increase in age beyond 40 years.” (opens the source at this quote in a new tab)
“Across all ethnic origins, individuals of African ancestry had the highest prevalence of glaucoma (6·11%, 95% CI 3·83–9·13) and primary open-angle glaucoma (5·40%, 3·17–8·27)” (opens the source at this quote in a new tab)
“High myopia with a myopic refractive error of roughly more than –8 diopters was another strong risk factor for glaucoma.” (opens the source at this quote in a new tab)

Heritability and the proportion of Mendelian disease

“Glaucoma, a highly heritable complex human disease, has an estimated heritability of 70%.” (opens the source at this quote in a new tab)
“Approximately 5% of primary OAG is Mendelian, with autosomal-dominant inheritance.” (opens the source at this quote in a new tab)

Familial risk among siblings of affected individuals

“Siblings of affected individuals have nearly an eight times increased risk of primary open-angle glaucoma and a five times increased risk of angle closure when compared with siblings of unaffected individuals.” (opens the source at this quote in a new tab)