The Prevalence of Primary Angle Closure Glaucoma in Adult Asians: A Systematic Review and Meta-Analysis

BackgroundPrimary angle closure glaucoma (PACG) is higher in Asians than Europeans and Africans, with over 80% of PACG worldwide in Asia. Previous estimates of PACG were based largely on early studies, mostly using inappropriate case definitions. Therefore, we did a systematic review and meta-analysis to estimate the prevalence of PACG in adult Asian populations and to quantify its association with age, gender, and region.MethodsAll primary reports of population-based studies that reported the prevalence of PACG in adult Asian populations were identified. PACG case definition was compatible with the ISGEO definition. Twenty-nine population-based studies were included. The overall pooled prevalence estimates were calculated using a random effect model, and ethnicity-, age- and gender-specific pooled prevalence estimates were also calculated.ResultsThe overall pooled prevalence of PACG in those of adult Asians was 0.75% (95% CI, 0.58, 0.96). Ethnicity-specific pooled prevalence estimates were 0.97% (0.22, 4.27) in Middle East group, 0.66% (0.23, 1.86) in South East Asia group, 0.46% (0.32, 0.64) in India group, 1.10% (0.85, 1.44) in China group, and 1.19% (0.35, 3.98) in Japan group, respectively. Age-specific prevalence was 0.21% (0.12, 0.37) for those 40–49 years, 0.54% (0.34, 0.85) for those 50–59 years, 1.26% (0.93, 1.71) for those 60–69 years, and 2.32% (1.74, 3.08) for those 70 years or above. The overall female to male ratio of the PACG prevalence was 1.51∶1 (95% CI 1.01, 2.28).ConclusionsPACG affects approximately 0.75% adult Asians, increasing double per decade, and 60% of cases being female. The prevalence rates vary greatly by ethnic region.

背景 原发性闭角型青光眼（Primary Angle Closure Glaucoma, PACG）在亚洲人群中的发病率高于欧洲人与非洲人，全球范围内超过80%的PACG患者分布于亚洲地区。此前的PACG患病率估算大多基于早期研究，且多数采用了不恰当的病例定义标准。因此，本研究开展了系统综述与荟萃分析，旨在估算亚洲成年人群中PACG的患病率，并量化其与年龄、性别及地域的关联。
研究方法 本研究检索了所有报道亚洲成年人群PACG患病率的基于人群的原创研究。本研究采用的PACG病例定义符合国际地理与流行病学眼科学会（ISGEO）的标准。最终纳入29项基于人群的研究。采用随机效应模型计算合并总体患病率，同时也分别按种族、年龄和性别计算了分层合并患病率。
研究结果 亚洲成年人群中PACG的总体合并患病率为0.75%（95%置信区间：0.58~0.96）。按种族分层的合并患病率分别为：中东人群组0.97%（95%置信区间：0.22~4.27）、东南亚人群组0.66%（95%置信区间：0.23~1.86）、印度人群组0.46%（95%置信区间：0.32~0.64）、中国人群组1.10%（95%置信区间：0.85~1.44）以及日本人群组1.19%（95%置信区间：0.35~3.98）。按年龄分层的患病率分别为：40~49岁人群0.21%（95%置信区间：0.12~0.37）、50~59岁人群0.54%（95%置信区间：0.34~0.85）、60~69岁人群1.26%（95%置信区间：0.93~1.71）以及70岁及以上人群2.32%（95%置信区间：1.74~3.08）。PACG患病率的女性与男性比值总体为1.51∶1（95%置信区间：1.01~2.28）。
研究结论 PACG影响约0.75%的亚洲成年人群，患病率每十年翻倍，且女性患者占比约60%。不同种族区域的患病率差异显著。