Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 5 Issue 3

Ocular Phenotypic Features of Adult-Onset Primary Open Angle Glaucoma in A Tertiary Hospital in Southern Nigeria

Onua AA and Ordinioha B*

School of Public Health, University of Port Harcourt, Nigeria

*Corresponding Author: B Ordinioha, School of Public Health, University of Port Harcourt, Nigeria.

Received: January 21, 2022; Published: February 10, 2022


Background/Objective: This was a prospective study of patients diagnosed with adult-onset Primary Open Angle Glaucoma (POAG) at the Glaucoma Clinic at the University of Port Harcourt Teaching Hospital, Nigeria. The objective of the study was to determine the ocular phenotypic features of patients with adult-onset glaucoma.

Materials and Methods: Clinical assessment of patients combined with findings from clinical records and interviewer administered semi-structured questionnaire were used to obtain data from the respondents between January and December 2021. Results: One thousand two hundred (n = 1200) adult POAG patients aged ≥ 40 years were recruited. The mean age of the subjects was 56.5 ± SD 22.3 years. Male-female ratio was 2.9:1. The mean central corneal thickness (CCT) was 532 ± SD 8.6 µm and average intraocular pressure (IOP) was 31.3 ± SD 11.2 mmHg. Nine hundred and three subjects (n = 903;75.3%) had high intraocular pressure (≥ 22 mmHg). Over 25% had poor ocular perfusion pressure (≤ 40mmHg). Six hundred and forty-seven (n = 647; 53.9%) had positive family history of glaucoma (first degree relatives) while 234 (19.5%) had positive family history of glaucoma (second degree relatives). Eight hundred and twenty (n = 820; 68.3%) subjects had cupping of the optic disc (VCDR ≥ 0.7). All the study participants had II to IV degree of open drainage angle on gonioscopy.

Conclusion: Thin CCT, high IOP, large VCDR poor OPP, and open drainage angle are noticeable ocular phenotypic features of adult-onset primary open angle glaucoma. Early detection through community-based case detection using these parameters could help in reducing the scourge from POAG.

Keywords: Adult-Onset Primary Open Angle Glaucoma; Phenotypic Features; Southern Nigeria


  1. Bourne RRA., et al. “Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis”. The Lancet Global Health9 (2017): e888-897.
  2. World Health Organization. Magnitude and cause of visual impairment. WHO Fact Sheet No. 282. Geneva: WHO (2019).
  3. Abdull MM., et al. “Causes of blindness and visual impairment in Nigeria: The Nigerian National Blindness and Visual Impairment Survey”. Investigative Ophthalmology and Visual Science 9 (2009): 4114-4120.
  4. Klein BE., et al. “Heritability of risk factors for primary open-angle glaucoma: The Beaver Dam Eye Study”. Investigative Ophthalmology and Visual Science 45 (2004): 59-62.
  5. Quigley HA and Broman AT. “The number of people with glaucoma worldwide in 2010 and 2020”. British Journal of Ophthalmology 90 (2006): 262-267.
  6. Pedro-Egbe CN., et al. “Blindness and Visual Impairment in the Niger-Delta: A study of Ahoada-East Local Government Area of Rivers State, Nigeria”. BMC Public Health 1 (2006): 56-61.
  7. Rotchford A. “What is practical in glaucoma management?” Eye 10 (2005): 1125-1132.
  8. Bowman RJ and Hay A. “Combined cataract and trabeculectomy surgery for advanced glaucoma in East Africa: visual and intra-ocular pressure outcomes”. Eye 24 (2010): 573-577.
  9. Adekoya BJ., et al. “Glaucoma in Southwest Nigeria: Clinical presentation, family history and perceptions”. International Ophthalmology 34 (2014): 1027-1036.
  10. Quingley HA., et al. “Optic nerve damage in human glaucoma III; quantitative correlation of nerve fibre loss and visual field defect in glaucoma, ischemic neuropathy, papilledema and toxic neuropathy”. Acta Ophthalmologica 100 (1982): 135-146.
  11. Toh TY., et al. “Central corneal thickness is highly heritable: the twin eye studies”. Investigative ophthalmology and Visual Science 10 (2005): 3718-3722.
  12. Chang TC., et al. “Determinants and heritability of intraocular pressure and cup-to-disc ratio in a defined older population”. Ophthalmology 112 (2005): 1186-1191.
  13. Klein BE., et al. “Heritability of risk factors for primary open-angle glaucoma: The Beaver Dam Eye Study”. Investigative Ophthalmology and Visual Science 45 (2004): 59-62.
  14. Van Koolwijk LM., et al. “Genetic contributions to glaucoma: heritability of intraocular pressure, retinal nerve fiber layer thickness, and optic disc morphology”. Investigative Ophthalmology and Visual Science 48 (2007): 3669-3676.
  15. Awoyesuku EA and Pedro-Egbe CN. “Clinical forms of glaucoma in a tertiary hospital in Nigeria”. Port Harcourt Medical Journal 6 (2012): 333-338.
  16. Kreft D., et al. “Prevalence, incidence, and risk factors of primary open-angle glaucoma - a cohort study based on longitudinal data from a German public health insurance”. BMC Public Health 19 (2019): 2295-2302.
  17. Friedman DS., et al. “The prevalence of open-angle Glaucoma among blacks and whites 73 years and older: the Salisbury eye evaluation Glaucoma study”. Archives of Ophthalmology 124 (2006): 1625-1630.
  18. Awoyesuku EA., et al. “The Port Harcourt Hospital Glaucoma Study”. British Journal of Medicine and Medical Research9 (2017): 1-6.
  19. Landers JA., et al. “Heritability of central corneal thickness in nuclear families”. Investigative Ophthalmology and Visual Science9 (2009): 4087-4090.
  20. Aghaian E., et al. “Central corneal thickness of Caucasians, Chinese, Hispanics, Filipinos, African Americans, and Japanese in a glaucoma clinic”. Ophthalmology12 (2004): 2211-2219.
  21. Wang SY., et al. “The impact of central corneal thickness on the risk for glaucoma in a large multiethnic population”. Journal of Glaucoma9 (2014): 606-612.
  22. Chua J., et al. “Ethnic differences of intraocular pressure and central corneal thickness: the Singapore Epidemiology of Eye Diseases study”. Ophthalmology10 (2014): 2013-2022.
  23. Pan CW., et al. “Ethnic Variations in Central Corneal Thickness in a Rural Population in China: The Yunnan Minority Eye Studies”. PloS one8 (2015): e0135913.
  24. Uche NJ., et al. “Central Corneal Thickness in an Adult Non-Glaucomatous Ethnic Population in Nigeria”. Research Square (2021).
  25. Wu J., et al. “Disease severity of familial glaucoma compared with sporadic glaucoma”. Archives of Ophthalmology 124 (2006): 950-954.
  26. Ramdas WD., et al. “Ocular perfusion pressure and the incidence of glaucoma: real effect of artifact? The Rotterdam Study”. Investigative Ophthalmology and Visual Science 52 (2011): 6875-6881.
  27. Oparil S., et al. “Pathogenesis of hypertension”. Annals of Internal Medicine 139 (2003): 761-776.
  28. Omoti AE., et al. “Vascular risk factors for open angle glaucoma in African eyes”. Middle East African Journal of Ophthalmology 16 (2009): 146-150.
  29. Xu L., et al. “Ocular perfusion pressure and glaucoma: the Beijing Eye Study”. Eye 23 (2009): 734-737.
  30. Memarzadeh F., et al. “Blood pressure, perfusion pressure, and open-angle glaucoma: the Los Angeles Latino Eye Study”. Investigative Ophthalmology and Visual Science 51 (2010): 2872-2877.
  31. Zheng Y., et al. “Distribution of ocular perfusion pressure and its relationship with open-angle glaucoma: the Singapore Malaysia eye study”. Investigative Ophthalmology and Visual Science 51 (2010): 3399-3404.
  32. Quigley HA., et al. “The prevalence of glaucoma in a population-based study of Hyspanic subjects: Proyecto VER”. Archives of Ophthalmology 119 (2001): 1819-1826.
  33. Mitchell P., et al. “Open-angle glaucoma and systemic hypertension: the blue mountains eye study”. Journal of Glaucoma 13 (2004): 319-326.
  34. Leske MC., et al. “Predictors of long-term progression in the early manifest glaucoma trial”. Ophthalmology 114 (2007): 1965-1972.
  35. Orzalesi N., et al. “Vascular risk factors in glaucoma: the results of a national survey”. Graefe's Archive for Clinical and Experimental Ophthalmology 245 (2007): 795-802.
  36. Carpel EF and Engstrom PF. “The normal cup-disk ratio”. Acta Scientific Ophthalmology 91 (1981): 588-597.
  37. O’Connor DJ., et al. “Comparison of methods to detect glaucomatous optic nerve damage”. Ophthalmology 100 (1993): 1498-503.


Citation: Onua AA and Ordinioha B. “Ocular Phenotypic Features of Adult-Onset Primary Open Angle Glaucoma in A Tertiary Hospital in Southern Nigeria".Acta Scientific Ophthalmology 5.3 (2022): 23-29.


Copyright: © 2022 Onua AA and Ordinioha B. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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