Determinants for late presentation of glaucoma among adult glaucomatous patients in University of Gondar Comprehensive Specialized Hospital. Case-control study

Abstract

Introduction Glaucoma is a disease which causes optic nerve damage and remains a major public health concern worldwide. Late presentation is a major risk factor for glaucoma induced blindness. The aim of this study was to assess determinants for late presentation of glaucoma among adult glaucomatous patients. Methods A hospital-based case-control study was conducted among 452 adult glaucomatous patients. Late presenters were glaucoma patients diagnosed with cup to disc ratio (CDR) > 0.8 and mean deviation of greater than -14 decibel in either of the eyes at their first presentation. Study participants were selected among glaucomatous follow-up patients by using systematic random sampling. Data were entered into EPI Info version 7 and exported to SPSS version 22 for analysis. Bivariable and multivariable logistic regression analysis was done to identify determinants. Variables with P-value < 0.05 were considered as statistically significant. Result The mean age of participants were 55.1 ± 13.2 years. Being > 60 years of age, 4.51 times (AOR: 4.51; 95% CI: 1.74, 11.67), resided > 53 km away from the hospital 6.02 times (AOR: 6.02; 2.76, 13.14), Presenting IOP > 30 mmHg, 4.49 times (AOR: 4.49, 95% CI: 2.10, 9.12), poor knowledge of glaucoma, 4.46 times (AOR: 4.46, CI: 2.62, 7.58) and absence of regular eye checkup, 2.35 times (AOR: 2.35, 95% CI: 1.09, 5.47) higher odds of being late presenter. Conclusion Increasing age, high IOP, poor knowledge of glaucoma, residing far away from the hospital and absence of regular eye checkups were significantly associated with late presentation.