Glaucoma Treatment Patterns in Sub-Saharan Africa.

Autor:	Olawoye O; Department of Ophthalmology, College of Medicine, University of Ibadan, Nigeria.; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, United Kingdom., Washaya J; Department of Ophthalmology, University of Zimbabwe, Zimbabwe., Gessesse GW; Department of Ophthalmology, St Pauls Millenium Hospital, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia., Balo K; Department of Ophthalmology, Sylvanus Olympio University Hospital, Lome Togo., Agre J; Department of Ophthalmology, The Eye Cliinic Bujumbura Burundi, West Africa., Macheka B; Department of Ophthalmology, Sekuru Kaguvi Hospital, Harare, Zimbabwe., Kizor-Akaraiwe N; Department of Ophthalmology, College of Medicine, Enugu State University of Technology, Enugu, Nigeria.; The Eye Specialists Hospital (TESH), Enugu, Nigeria., Pons J; Department of Ophthalmology, Good Shepherd Hospital, Siteki, Eswatini., Sarimiye T; Department of Ophthalmology, College of Medicine, University of Ibadan, Nigeria., Ashaye A; Department of Ophthalmology, College of Medicine, University of Ibadan, Nigeria., Garba F; Department of Ophthalmology, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria., Chitedze R; The Eyes of Africa, Child-Legacy International, Malawi., Ibanga A; Department of Ophthalmology, College of Medical Sciences, University of Nigeria Ituku-Ozalla Campus Enugu Nigeria., Mahdi A; Department of Ophthalmology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria., Ogunro A; Eye Foundation Hospital Group, Nigeria., Budengeri P; Department of Ophthalmology, Clinique de l'Oeil de Bujumbura, Burundi (Ophthalmology centre Siloam Abidjan)., Ajibode HA; Department of Ophthalmology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria., Tamrat L; St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia., Onakoya A; Department of Ophthalmology, Lagos University Teaching Hospital Idi Araba, Lagos, Nigeria., Okeke S; Enugu State University of Science and Technology, Esut Parklane, Enugu, Nigeria., Giorgis AT; Department of Ophthalmology, SM, CHS, Addis Ababa University of Michigan School Michigan United States., Okosa CC; Department of Ophthalmology, College of Medicine, University of Nigeria, Ituku-Ozalla campus., Fowobaje K; Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria., Cook S; The Eye Centre East London South Africa., Lawrence S; Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI., Chan VF; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, United Kingdom., Azuara-Blanco A; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, United Kingdom., Congdon N; Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, United Kingdom.; Orbis International, New York, NY., Realini T; Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV.
Jazyk:	angličtina
Zdroj:	Journal of glaucoma [J Glaucoma] 2023 Oct 01; Vol. 32 (10), pp. 815-819. Date of Electronic Publication: 2023 Jul 21.
DOI:	10.1097/IJG.0000000000002273
Abstrakt:	Prcis: Physicians were most likely to recommend primary medical therapy upon diagnosis of glaucoma. Laser therapy was underutilized where they were available. Physicians were more likely to recommend surgery in severe glaucoma, laser therapy in mild glaucoma, while recommendation of medical therapy did not depend on glaucoma severity. Purpose: To characterize treatment patterns for newly diagnosed glaucoma in sub-Saharan Africa (SSA). Methods: This was a multicenter cross-sectional study of adults newly diagnosed with glaucoma at 27 eye care centers in 10 African countries. In addition to demographic and clinical data, physician treatment recommendations (medication, laser, surgery, or no treatment) were recorded. Statistical analyses were performed using STATA version 14.0. Results: Data from 1201 patients were analyzed. Physicians were most likely to recommend primary medical therapy upon diagnosis of glaucoma (69.4%), with laser (13.2%), surgery (14.9%), and no treatment (2.5%) recommended to the remaining patients. All sites had medical therapy available and most (25/27, 92.6%) could provide surgical treatment; only 16/27 (59.3%) sites offered laser, and at these sites, 30.8% of eyes were recommended to undergo primary laser procedures. As glaucoma severity increased, the laser was recommended less, surgery more, and medications unchanged. Patient acceptance of medical therapy was 99.1%, laser 88.3%, and surgery 69.3%. Conclusions: Medical therapy for first-line glaucoma management is preferred by most physicians in SSA (69%). Laser therapy may be underutilized at centers where it is available. These findings underscore the need for comparative studies of glaucoma treatments in SSA to inform the development of evidence-based treatment guidelines and of programs to reduce glaucoma blindness in SSA. Strategic approaches to glaucoma therapy in SSA must address the question of whether medical therapy is the most optimal first-line approach in this setting. Competing Interests: N.C. received funding from Orbis International, Zhongshan Ophthalmic Center, Sun Yat-sen University, Bayer, Ulverscroft Foundation (UK), and Belkin Laser. He also serves as a paid consultant for Belkin Vision, a company selling devices for the treatment of glaucoma. O.O. received funding from the Consortium for Advanced Training and Research in Africa (CARTA). She is a CARTA fellow. The remaining authors declare no conflict of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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