Abstract

DO.26.10

Glaucoma Screening in Western Cameroun

Faustin Ngounou1, Gabriel Kougan1, James Tamon1, Allegra Großmann2, Paul-Rolf Preußner2
1Presbyterian Eye Services Acha Annex, Bafoussam, Cameroon; 2Universitäts-Augenklinik Mainz, Mainz, Deutschland

Objective
To quantify glaucoma-related parameters in a rural African area.
Methods
635 persons in 6 villages underwent slit-lamp examination including investigation of the optic nerve head with a 90D lens and Goldmann applanation tonometry. The mean age of the persons was 49.4±19 years, minimum 5, maximum 90, median 52 years. The inferior, superior, nasal and temporal margin width of the optic nerve head were estimated as fractions of the total disk diameter thus allowing the evaluation of the horizontal and vertical cup-disk-ratio (CDR), the ratio of the elliptical cup area to the total disk area (area CDR), and violations of the ISNT-rule.
Results
Area CDR significantly increased with age, on average from 0.1 in the youngest to 0.47 in the oldest persons, corresponding to an increase of linear CDR from 0.32 to 0.68. The total fraction of eyes exceeding an area CDR of 0.5 (i.e. linear 0.7) was 13.4%. Also the intraocular pressure (IOP) increased on average from 14mmHg in the youngest to 20mmHg in the oldest persons, but nevertheless many high CDR values were found in eyes with normal to moderately elevated IOP. Violations of the ISNT-rule were found in ≈25% of the eyes. Application of a combination of glaucoma criteria as commonly accepted in literature resulted in a total prevalence of 18.7% of the screened persons, corresponding to a prevalence of 8.2% after age correction for the – on average – very young Camerounian population.
Conclusions
Compared to Europe, glaucoma prevalence appears nearly an order of magnitude higher in this rural African population.

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