The Barbados eye study

ABSTRACT

OBJECTIVE: To describe the design of the Barbados Eye Study and report of the prevalence of open angle glaucoma (OAG) in a predominantly black study population. DESIGN: Population-bases prevalence study. SETTING AND PARTICIPATION Residents of Barbados, West Indies, identified from a simple random sample of Barbadian-born citizens 40 through 84 years old. DATA COLLECTION Participants had a comprehensive study visit that included automated perimetry, applanation tonometry, and fundus photography; persons with specific findings, as well as a 10 percent sample of participants, were referred for an ophthalmologic exanimation and additional tests. OUTCOME: A diagnosis of OAG required both visual field and optic disc criteria for glaucoma damage after excluding other causes. RESULTS: The 4709 participants (83.5 percent of those eligible) had demographic characteristics that were similar to the census population. Of the 4631 participants who were tested at the study site, 95 percent completed Humphrey automated perimetry and 97 percent had photographic or clinical disc gradings; 93 percent of those referred completed the ophthalmologic examination. In the adult population, the prevalence of OAG by self-reported race was 7.0 percent (302/4314) in black, 3.3 percent (6/184) in mixed race, and 0.8 percent (1/1`33) in white or other participants. In black and mixed-race participants, the prevalence reached 12 percent at age 60 years and older and was higher in men (8.3 percent) than in women (5.7 percent), with and age-adjusted male-female ratio of 1.4. In addition, over 3 percent of the participants were classified as having suspect OAG. CONCLUSIONS: To our knowledge, the Barbados Eye Study is the largest glaucoma study ever conducted in a black population and identified more people with OAG than did any previous population study. The prevalence of OAG was high, especially at older ages and in men. Among participants 50 years old or older, one in 11 had OAG, and prevalence increased to one in six at age 70 years or older. The results highlights the public health importance of OAG in the Afro-Caribbean region and have implications for other populations. (AU)