The additional yield of screening for open-angle glaucoma in a population with high prevalence of pseudoexfoliation: The Thessaloniki Eye Study.

Authors

Dimitrios A Giannoulis, Anne L Coleman, Masao Roy Wilson, Alon Harris, Evangelia Papakonstantinou, Panagiota Ntonti, Fei Yu, Vassilis Kilintzis, Anna-Bettina Haidich, Theofanis Pappas, Eleftherios Anastasopoulos, Iordanis Vagiakis, Anastasia Raptou, Grigoria Tzoanou, Fotis Topouzis

Published in

Acta ophthalmologica. Aug 03, 2026. Epub Aug 03, 2026.

Abstract

To identify incident open-angle glaucoma (OAG) cases detected through regular ophthalmic care and from screening in a population-based cohort and study the additional yield of screening in a population with high prevalence of pseudoexfoliation (PEX).
Longitudinal, population-based study in Thessaloniki, Greece. Among eligible subjects, 1092 were examined at the follow-up stage. Previously undiagnosed glaucoma was defined as the absence of prior self-reported glaucoma or ocular hypertension or prior medical/surgical treatment. Glaucoma severity was assessed using the Hodapp-Parrish-Anderson criteria.
The population at risk, after excluding glaucoma patients diagnosed at baseline, consisted of 1042 participants. Forty-six subjects developed incident OAG and 27 of them (58.7%, 95% CI: 43.5-71.7) were undiagnosed at follow-up visit, corresponding to a 2.6% (95% CI: 1.6-3.6) 12-year incidence rate of undiagnosed OAG. After stratification, the incidence of undiagnosed OAG was 1.8% in non-PEX subjects (14 of 772) and 4.8% in PEX subjects (13 of 270). Glaucoma stage did not differ significantly between previously diagnosed and undiagnosed cases (p = 0.46 for better eye and p = 0.72 for worse eye). Among undiagnosed cases, 7 had moderate or worse visual field loss in both eyes, and 17 in at least one eye.
The overall rate of undiagnosed incident OAG in this population-based cohort was substantial. A screening programme could have detected a significant number of glaucoma cases. The high rates of undiagnosed glaucoma among PEX subjects could suggest a higher additional yield of screening in this group. More studies are needed to evaluate the cost-effectiveness of screening in populations with high PEX prevalence.

PMID:
42544889
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.

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