OBJECTIVE: To determine the demographic and clinical profile of glaucoma patients seen in a Philippine tertiary hospital from 2011 to 2014.

METHOD: Medical records of glaucoma patients managed at the outpatient ophthalmology clinic from October 2010 to August 2014 were reviewed. Diagnosis of glaucoma was based on the International Society of Geographic and Epidemiological Ophthalmology (ISGEO) guidelines. The demographics, clinical profile, functional severity scoring, and initial management of patients were described.

RESULT: Majority of the 570 patients were females (60.17%), with a mean age of 56.23 years. Eighty-five percent claimed to have no family history of glaucoma. The mean best-corrected visual acuity (BCVA) was 0.40, the mean intraocular pressure (IOP) was 23.56 mmHg, and the mean cup-to-disc (CD) ratio was 0.69. There were more primary type of glaucoma (55.48%) than secondary glaucoma. Mixed pattern was the most common type of visual field pattern at initial presentation. Majority of the defects were under GSS 2 stage 2 of mean deviation (MD) and loss variance (LV). Medical treatment was the most common initial management given to glaucoma patients.

CONCLUSION: The primary glaucomas were more common than the secondary glaucomas seen in a private tertiary hospital. Most had moderate visual field damage (mixed type pattern) and the most common initial management given was medical treatment.

KEYWORD: Glaucoma, Epidemiology, Primary open angle glaucoma, Primary angle closure glaucoma, Secondary glaucoma, Normal tension glaucoma, ISGEO guidelines

Human ; Male ; Female ; Middle Aged ; Intraocular Pressure ; Low Tension Glaucoma ; Ophthalmology ; Glaucoma, Angle-closure ; Glaucoma, Primary Open Angle ; Glaucoma, Open-angle ; Tetrahymenina

Introduction: The aim of this study was to investigate the clinical effectiveness, health related quality of life (HRQoL) and cost effectiveness of selective laser trabeculoplasty (SLT) compared to topical anti-glaucoma medications in step-up treatment of patients with primary open angle glaucoma (POAG). Methods: Seventeen POAG patients with suboptimal IOP control despite pre-existing topical medications were subjected to adjunct SLT (50 applications 180 degrees) or second line medical therapy. Current medications were continued, and patients were followed up for 6 months for degree of intraocular pressure (IOP) lowering. HRQoL was assessed using Glaucoma Quality of Life 36-item (GlauQoL-36), Assessment of Quality of Life-7D (AQoL-7D) and Vision related Quality of Life (VisQoL). Costs involved were calculated and compared to the effect (IOP reduction) achieved in each arm. Results: Ten patients were in the SLT group and 7 in the topical medication (MED) group. Mean baseline intraocular pressure (IOP) was 18.90±3.48mmHg in SLT group and 15.57±2.23mmHg in MED group. Mean reduction of IOP was 4.30±1.64mmHg in SLT group and 2.71±2.56 mmHg in MED group at 6 months which was not statistically significant (p=0.14) between two groups. All the HRQoL questionnaires did not show significant changes in the groups or between groups when compared baseline with 6-month post treatment (p-values ranging from 0.247 to 0.987). For every 1mmHg reduction in IOP, cost involved in MED group (RM53.61) was 165% of the cost involved in SLT group (RM32.56). Discussion and Conclusion: This study has shown that SLT was as effective clinically and tolerable as topical anti glaucoma medications and was possibly more cost effective in the step-up treatment of patients with POAG at 6 months follow- up.
selective laser traeculoplasty ; topical antiglaucoma, clinical effectiveness ; quality o0f life ; cost effectiveness ; primary open angle glaucoma ; prospective pilot cohort study