Purpose: To report the prevalence, long-term changes and associated factors for pseudoexfoliation (PEX) in a population aged 40 years and above from rural and urban south India.
Materials and methods: At baseline (the Chennai Glaucoma Study), 7774 subjects were examined. After 6 years, as a part of the incidence study, 133 of the 290 subjects diagnosed with PEX at baseline were reexamined for long-term changes. Participants had detailed examination at base hospital.
Results: At baseline PEX was noted in 290 [3.73%, 95% confidence interval (CI), 3.3-4.2] subjects. It was associated with glaucoma in 24 (8.3%), ocular hypertension (OHT) in 21 (7.2%), and occludable angles in 24 (8.3%) subjects. The age-adjusted and sex-adjusted prevalence was 3.41% (95% CI, 3.39-3.43). Increasing age was a significant associated factor. Using the 40- to 49-year age group as a reference, the odds ratio increased from 8.4 (95% CI, 4.1-17.1) for the 50- to 59-year age group to 51.2 (95% CI, 25.8-101.6) for the 70 years and above age group. Other associated factors were rural residence (P<0.001), higher intraocular pressure (P<0.001), cataract (P<0.001), being underweight (P=0.01), manual labor (P=0.03), and aphakia (P<0.001). Of the 133 subjects reexamined, 8 (6.0%) subjects developed glaucoma and all had OHT at baseline. Rates of cataract surgery were (P<0.001) higher in subjects with PEX.
Conclusion: Prevalence of PEX was higher in rural population and baseline OHT was a significant factor for conversion to glaucoma.