Incidence of acute angle-closure glaucoma in Dalmatia, southern Croatia.

Aim: To investigate the incidence of acute angle-closure glaucoma among residents of Dalmatia, southern part of Croatia.

Methods: We reviewed hospital records of 176 patients with acute angle-closure glaucoma treated between January 1995 and December 2001 at the Departments of Ophthalmology at four hospitals in Dalmatia. There were 122 women, aged between 29 and 89 years (median age; 68 years), and 54 men, aged between 33 and 88 years (median age, 70 years).

Results: The unadjusted crude incidence was 2.9/100,000 (95% confidence interval [CI], 1.6-4.5). The unadjusted crude incidence among men and women was 1.9 (95% CI, 0.3-3.8) and 3.9 (95% CI, 1.7-6.1) cases/100,000 per year, respectively. The relative risk (RR) of developing acute angle-closure glaucoma was 2.1 (95% CI, 1.5-2.9) times higher for women as compared to men. The RR of acute angle-closure glaucoma was 1.9 (95% CI, 0.6-6.2) in the 40-49 years group, 6.5 (95% CI, 2.3-18.8) in the 50-59 years group, 17 (95% CI, 6.3-47.8) in the 60-69 years group, and 28 (95% CI, 10.4-77.3) in the over 69 years group. The median time from the onset of symptoms to presentation at the hospital was 2 days (range, 1-15 days). In 87 (48%) patients intraocular pressure control was achieved by medical treatment, 41 (23%) patients underwent peripheral iridectomy, and 48 (27%) patients required a trabeculectomy. In 35 (73%) out of 48 patients managed by filtering surgery, the delay in treatment was 3 or more days. In 34 (19%) eyes with final visual acuity 0.1 or worse, the delay in presentation was 3 days or more. No statistically significant association was found between acute angle-closure glaucoma and seasonal variation (chi-square=0.85; p=0.8).

Conclusion: Earlier recognition of the patients with acute angle-closure glaucoma and a shorter time of delay in presentation could have saved many patients from surgery and vision loss each decade.