A comparative study of anterior segment variables between glaucomatous and non-glaucomatous Ghanaians.

Clinical Relevance: Primary open-angle glaucoma is a major public health concern, particularly in Africa. Identifying population-specific risk factors for the disease will enable eye health clinicians to more precisely identify persons at risk for the disease.

Background: Ghana has a high prevalence of primary open-angle glaucoma. This study compared anterior segment ocular variables associated with primary open-angle glaucoma between a glaucomatous and non-glaucomatous Ghanaian population which may provide more insight into the aetiology of the disease.

Methods: Central corneal thickness, corneal diameter, corneal volume, anterior chamber angle, anterior chamber depth, and anterior chamber volume measurements were extracted from Pentacam results of 356 persons with primary open-angle glaucoma (mean age: 62.84 ± 14.59) and 311 controls (mean age: 60.80 ± 9.09). Intraocular pressure was measured using Goldmann applanation tonometry. Analysis of variance was used to compare means the measured ocular variables among the primary open-angle glaucoma and control groups. Cohen's d effect sizes and multivariate logistic regression were used to determine the primary open-angle glaucoma effect sizes and associations between primary open-angle glaucoma and the measured variables.

Results: Thinner central corneal measurements were moderately associated with severe primary open-angle glaucoma (aOR = 0.59; 95% CI: 0.40-0.87). Lower corneal volume measurements were associated with moderate primary open-angle glaucoma (aOR = 0.63; 95% CI: 0.40-0.99) and highly associated with severe primary open-angle glaucoma (aOR = 0.47; 95% CI: 0.32-0.70). Elevated intraocular pressure was highly associated with all stages of primary open-angle glaucoma (aOR > 4.02), with the strength of this association increasing with severity of primary open-angle glaucoma.

Conclusion: Risk factors for different stages of severity of primary open-angle glaucoma are revealed. Thinner central corneas, lower corneal volumes, and elevated intraocular pressure measurements are risk factors for primary open-angle glaucoma in Ghanaians.