The reasons for late diagnosis and epidemiological features of glaucoma in the North-eastern region of the Arabian Peninsula

PURPOSE: to study the causes of late diagnosis and clinical features of glaucoma in the North-eastern region of the Arabian Peninsula on the example of Kuwait country. METHODS: 620 patients with glaucoma, who sought medical help in Kuwait Oil Company Ahmadi Hospital, were included in the study. They underwent standard ophthalmic examination (subjective visometry with Snellen chart, computer perimetry, gonioscopy, refractometry, biomicroscopy, ophthalmoscopy, Goldmann tonometry) and filled out a specially designed questionnaire. The obtained data were statistically processed and analyzed. RESULTS: Among the reasons of late glaucoma diagnosisthat we selected the leading role belonged to the lack of symptoms, especially in the early stages of disease. By the degree of significance the risk factors of severe glaucoma were located as follows: age, climatic and geographic region of residence, type of glaucoma, the degree of urbanization. The level of intraocular pressure and detection of late (III, IV) stages of glaucoma were increased in the older age groups, which is consistent with the global statistics. A comparative analysis of intraocular pressure in flatland patients (95% CI 25.39±0.24 mm Hg) and coastal patients (95% CI 21.87±0.19 mm Hg) with the Student's T test showed with a high significance (p<0.001) a higher IOP in the flatland region as a whole and in specific subgroups by gender, degree of urbanization and type of glaucoma. The analysis of the dependence of glaucoma stages on the region of residence using Pearson's Chi-squared test revealed a significantly (р=0.005) more severe open angle glaucoma in the flatland region compared to the coastal. In the inhabitants of the flatland area, citizen's intraocular pressure was significantly higher than that of rural residents, while the inhabitants of the coastal area showed no significant difference in IOP in similar groups. Intraocular pressure for citizen residents in the flatland were (95% CI 25.66±0.37 mm Hg), while for rural residents at the same region - (95% CI 25.16±0.3 mm Hg). Student's T test showed significant (р=0.037) difference in these groups. CONCLUSION: Asymptomatic early stages of glaucoma are the leading cause of its late detection in Kuwait. Local climatic and geographic factors play a significant role in the epidemiology of glaucoma in the region. The data can be used to develop measures to prevent blindness from glaucoma in this country.

глаукома, Кувейт, факторы риска, климато-географические факторы, glaucoma, Kuwait, risk factors, climatic and geographical factors

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