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Purpose: To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma.

Design: Retrospective analysis.

Participants: A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia.

Methods: Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario.

Main Outcome Measures: Detection rates of glaucoma-related diagnoses and types of treatments administered.

Results: Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT, and 103 (6.2%) who were prescribed IOP-lowering medication.

Conclusions: Targeting individuals at risk for glaucoma in underserved communities in Philadelphia yielded a high detection rate (39.1%) of glaucoma-related diagnoses. Providing examinations and offering treatment, including first-line laser procedures, at community-based sites providing services to older adults are effective to improve access to eye care by underserved populations.

Titel:	The Philadelphia Glaucoma Detection and Treatment Project: Detection Rates and Initial Management.
Autor/in / Beteiligte Person:	Waisbourd, M ; Pruzan, NL ; Johnson, D ; Ugorets, A ; Crews, JE ; Saaddine, JB ; Henderer, JD ; Hark, LA ; Katz, LJ
Zeitschrift:	Ophthalmology, Jg. 123 (2016-08-01), Heft 8, S. 1667-1674
Veröffentlichung:	2000- : New York : Elsevier ; <i>Original Publication</i>: Rochester, Minn., American Academy of Ophthalmology., 2016
Medientyp:	academicJournal
ISSN:	1549-4713 (electronic)
DOI:	10.1016/j.ophtha.2016.04.031
Schlagwort:	Black or African American ethnology Aged Aged, 80 and over Corneal Pachymetry Female Glaucoma, Angle-Closure ethnology Glaucoma, Open-Angle ethnology Gonioscopy Humans Intraocular Pressure physiology Male Middle Aged Ocular Hypertension diagnosis Ocular Hypertension ethnology Ocular Hypertension therapy Philadelphia epidemiology Retrospective Studies Tonometry, Ocular Visual Acuity physiology Visual Fields physiology Antihypertensive Agents therapeutic use Glaucoma, Angle-Closure diagnosis Glaucoma, Angle-Closure therapy Glaucoma, Open-Angle diagnosis Glaucoma, Open-Angle therapy Iridectomy Trabeculectomy
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S. Language: English [Ophthalmology] 2016 Aug; Vol. 123 (8), pp. 1667-1674. <i>Date of Electronic Publication: </i>2016 May 22. MeSH Terms: Iridectomy* ; Trabeculectomy* ; Antihypertensive Agents / therapeutic use ; Glaucoma, Angle-Closure / diagnosis ; Glaucoma, Angle-Closure / therapy ; Glaucoma, Open-Angle / diagnosis ; Glaucoma, Open-Angle / *therapy ; Black or African American / ethnology ; Aged ; Aged, 80 and over ; Corneal Pachymetry ; Female ; Glaucoma, Angle-Closure / ethnology ; Glaucoma, Open-Angle / ethnology ; Gonioscopy ; Humans ; Intraocular Pressure / physiology ; Male ; Middle Aged ; Ocular Hypertension / diagnosis ; Ocular Hypertension / ethnology ; Ocular Hypertension / therapy ; Philadelphia / epidemiology ; Retrospective Studies ; Tonometry, Ocular ; Visual Acuity / physiology ; Visual Fields / physiology References: Ophthalmology. 1989 Sep;96(9):1363-8. (PMID: 2789357) ; Arch Ophthalmol. 1991 Aug;109(8):1090-5. (PMID: 1867550) ; Am J Ophthalmol. 2008 Jan;145(1):3-4. (PMID: 18154749) ; Arch Ophthalmol. 1980 Dec;98(12):2163-71. (PMID: 7447768) ; Ophthalmology. 2009 May;116(5):823-32. (PMID: 19285730) ; Arch Ophthalmol. 1995 Jul;113(7):918-24. (PMID: 7605285) ; Patient Educ Couns. 2016 Apr;99(4):659-664. (PMID: 26686991) ; Br J Ophthalmol. 2006 Mar;90(3):262-7. (PMID: 16488940) ; Ophthalmic Epidemiol. 2013 Aug;20(4):201-11. (PMID: 23865601) ; PLoS One. 2014 Dec 30;9(12):e115942. (PMID: 25549331) ; Ophthalmology. 2000 Feb;107(2):303-8. (PMID: 10690830) ; Arch Ophthalmol. 2002 Jun;120(6):701-13; discussion 829-30. (PMID: 12049574) ; N Engl J Med. 1991 Nov 14;325(20):1412-7. (PMID: 1922252) ; Ophthalmology. 2004 Aug;111(8):1439-48. (PMID: 15288969) ; JAMA. 1991 Jul 17;266(3):369-74. (PMID: 2056646) ; Surv Ophthalmol. 2008 Nov;53 Suppl1:S3-10. (PMID: 19038621) ; Int Ophthalmol Clin. 2004 Spring;44(2):43-60. (PMID: 15087730) ; Br J Ophthalmol. 1996 May;80(5):389-93. (PMID: 8695555) ; Arch Ophthalmol. 2012 Mar;130(3):365-72. (PMID: 22411665) ; Ophthalmology. 2015 Apr;122(4):711-20. (PMID: 25576993) ; Am J Ophthalmol. 1998 Oct;126(4):487-97. (PMID: 9780093) ; Arch Ophthalmol. 1994 Jun;112(6):821-9. (PMID: 8002842) ; Ophthalmic Epidemiol. 2016;23(2):122-130. (PMID: 26950056) ; Ophthalmology. 2007 May;114(5):833-4. (PMID: 17467523) ; J Health Care Poor Underserved. 2013 Aug;24(3):1042-52. (PMID: 23974379) ; Arch Ophthalmol. 2006 Dec;124(12):1754-60. (PMID: 17159036) ; Arch Ophthalmol. 2000 Feb;118(2):253-6. (PMID: 10676791) ; Arch Ophthalmol. 2004 Apr;122(4):532-8. (PMID: 15078671) ; Arch Ophthalmol. 1998 Dec;116(12):1640-5. (PMID: 9869795) ; Br J Ophthalmol. 2012 Sep;96(9):1162-7. (PMID: 22653314) ; Ann Intern Med. 2013 Oct 1;159(7):484-9. (PMID: 24325017) ; J Glaucoma. 2016 May;25(5):e520-5. (PMID: 26900823) ; Ophthalmology. 2014 Nov;121(11):2081-90. (PMID: 24974815) ; Arch Ophthalmol. 2001 Dec;119(12):1819-26. (PMID: 11735794) ; Arch Ophthalmol. 2006 Nov;124(11):1625-30. (PMID: 17102012) ; J Glaucoma. 2016 Oct;25(10):e821-e825. (PMID: 26950579) Grant Information: CC999999 United States ImCDC Intramural CDC HHS; U58 DP004060 United States DP NCCDPHP CDC HHS Contributed Indexing: Indexing Agency: NLM Local ID #: HHSPA794055 [Available on 08/01/17]. Substance Nomenclature: 0 (Antihypertensive Agents) Entry Date(s): Date Created: 20160526 Date Completed: 20170630 Latest Revision: 20240610 Update Code: 20240610 PubMed Central ID: PMC4958560

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The Philadelphia Glaucoma Detection and Treatment Project: Detection Rates and Initial Management.