Glaucoma in Kilimanjaro: A Hospital-Based Retrospective Cross-Sectional Study

Abstract

Aim: The study aims to determine the magnitude of glaucoma at KCMC and assess the efficacy of treatment. Study Design: This was a hospital-based retrospective cross-sectional study. Place and Duration of Study: The study was conducted in the Eye Department of Kilimanjaro Christian                                             Medical Centre in Moshi, Tanzania, and data collection and analysis were performed between 04 September 2013 and 04 September 2014. Methodology: This was a hospital-based retrospective cross-sectional study conducted at the Eye Department of                      Kilimanjaro Christian Medical Centre in Moshi, Tanzania, and included all patients coded as glaucomatous who attended in 2012. It was descriptive and observational, with the main outcome measures being Snellen visual acuity, intraocular pressure in mmHg, optic disc excavation, and visual field score in decibels. Statistical Package for Social Sciences version 16.1 was employed. Results: There were 847 glaucomatous patients with a mean age of 61.38 years (SD 21.42); 518 were male and 329 were female. Primary open-angle glaucoma was the most common type, accounting for 85.4%. Mean intraocular pressure at diagnosis was 27.45 mmHg in the right eyes and decreased to 19.36 mmHg over a mean follow-up period of 3.86 years. There was an 11.11 mmHg reduction in intraocular pressure in the trabeculectomy group compared with a 6.35 mmHg reduction in the Timolol-eye-drops-only group. Cupping progressed in both eyes, but this was not found to be statistically significant. At diagnosis, 15.1% of the patients were blind according to the WHO classification; this proportion increased to 16.1% at the last visit. Some 55 patients progressed to visual impairment when visual acuity in the better eye was considered, while 36 eyes showed improved vision when visual acuity in the worst affected eye was considered. Conclusions: Patients presented late at diagnosis; however, there was a good response to treatment, with a reasonable reduction in intraocular pressure and no rapid progression of visual impairment, suggesting that the therapeutic approach at KCMC was efficacious.