Incidence of open-angle glaucoma in a general elderly population: The Rotterdam Study

Purpose: To determine the incidence of open-angle glaucoma (OAG) in a general elderly white population. Design: Population-based cohort study. Participants: Participants 55 years and older from the Rotterdam Study, The Netherlands. Methods: Participants at risk for incident OAG underwent at baseline (1990-1993) and follow-up (1997-1999) the same ophthalmic examination, including measurement of intraocular pressure, visual field testing, and stereo optic disc photography. The diagnosis of probable or definite OAG was made with an algorithm based on optic disc parameters and on visual field testing, independent of the intraocular pressure. Main Outcome Measures: Five-year risk and incidence rates of OAG. Results: In total, 3842 participants were examined (participation rate at follow-up, 78%). After a mean follow-up time of 6.5 years, probable (n = 58) or definite OAG (n = 29) developed in 87 persons. The 5-year risk of probable OAG was 1.2% and that of definite OAG 0.6%, and the rate rose for both together from 1% at age 60 years to approximately 3% at age 80 years. Bilateral OAG occurred 5 times more often after than before age 75 years. In participants with prevalent OAG in 1 eye, the 5-year risk of OAG in the fellow eye was 5 times higher than in fellow eyes of non-OAG eyes. Only 37% of the incident cases received treatment for OAG at the time of the reexamination. Conclusions: The incidence of OAG rose significantly with age. Most of the patients with incident OAG were unaware of having OAG.

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