Characteristics of Undiagnosed Primary Open-Angle Glaucoma: The Tajimi Study

Purpose: To evaluate the characteristics of patients with previously undiagnosed primary open-angle glaucoma (POAG) in the Tajimi Study. Methods: Background and ophthalmic examination data from 111 patients previously undiagnosed with POAG from the Tajimi Study, a population-based survey of glaucoma, were analyzed and compared with those of eight patients with previously diagnosed glaucoma. Results: The mean deviation (MD) and vertical cup-to-disc ratio (vC/D) of the worse eye of each patient averaged -5.5 decibels (dB) and 0.72 and -10.4 dB and 0.83, respectively, in undiagnosed and diagnosed POAG. In undiagnosed POAG, arcuate and partial arcuate patterns accounted for 50% of the pattern of the visual field (VF) damage, and 95% of patients presented with intraocular pressure of 21mmHg or less (normal tension glaucoma). The undiagnosed group had better MD and smaller vC/D values in the worse eye and less involvement of bilateral VFs than the diagnosed group (p = 0.004-0.050 with Bonferroni correction), while other factors, including mean sensitivity of the binocular VF, showed no intergroup difference. Conclusion: The characteristics of Japanese patients with previously undiagnosed POAG indicated that bilateral evaluation of the optic disc and VF are important for identifying individuals with glaucoma.