Abstract:
ABSTRACT
Introduction: Glaucoma is among the leading causes of irreversible blindness
in developing countries including Ethiopia. It remains as a major public health
concern that impedes the quality of life of patients and late presentation has
significantly contributed for the increased incidence of blindness. Though late
presentation is a major risk factor for glaucoma induced blindness, there is
paucity of information on the determinants for the late presentation and the
predictive ability of intra ocular pressure for the diagnosis of late glaucoma.
Objective: To assess determinants for late presentation of glaucoma and the
predictive accuracy of intra ocular pressure to diagnose late glaucoma among
glaucomatous patients attending University of Gondar tertiary eye care and
training center.
Methods: A hospital-based unmatched case control study (1:1) was
conducted on 492 patients. Data was entered into EPI Info and exported to
SPSS version 22 for analysis. Bivariable and multivariable logistic regression
was used to identify determinants. Variables with p<0.05 was considered as
statistically significant. Receiver operating characteristic curve analysis was
done to determine the predictive accuracy of baseline intra ocular pressure to
diagnose late glaucoma.
Result: From the total of 492 study participants, 452 (91.87%) responded to
the survey. The mean age was 55.12 with a standard deviation of 13.22. Being
> 60 years of age (AOR: 4.51; 95% CI: 1.74, 11.67), resided > 53 Km ) away
from the University of Gondar hospital (AOR: 6.02; 2.76, 13.14), presenting
intra ocular pressure of > 30 mmHg (AOR: 4.49, 95% CI: 2.10, 9.12), poorly
knowledgeable about glaucoma (AOR: 4.46, CI: 2.62, 7.58) were significantly
associated with late presentation of glaucoma. On the other hand, regular eye
checkup (AOR: 0.42, 95% CI: 0.18, 0.98) and having a known history of
diabetes mellitus (AOR = 0.16, 95% CI: 0.68, 0.38) were protective against late
presentation of glaucoma. The receiver operating characteristic curve analysis
showed that area under the curve of 0.674 and a cut-off intra ocular pressure
? 25.03 mmHg.
Conclusion: Increasing age, intra ocular pressure, Poor knowledge about
glaucoma and those who resided at far distance from University of Gondar
tertiary eye care and training center had strong positive association with late
presentation of glaucoma. Known history of diabetes mellitus and regular eye
checkup were associated negatively with late glaucoma. The predictive
accuracy of intra ocular pressure as a diagnostic consideration for late
glaucoma was poor.
Key words: Glaucoma, Determinants, IOP, Late presentation, ROC curve
