Glaucoma treatment patterns in Sub-Saharan Africa

Olusola Olawoye, Jennifer Washaya, Girum W. Gessesse, Komi Balo, Jeremie Agre, Boniface Macheka, Nkiru Kizor Akaraiwe, Jonathan Pons, Tarela Sarimiye, Adeyinka Ashaye, Farouk Garba, Richard Chitedze, Affiong Ibanga, Abdull Mahdi, Adunola Ogunro, Patrick Budengeri, Haroun Adetunji Ajibode, Lemlem Tamrat, Adeola Onakoya, Suhanyah OkekeAbeba T. Giorgis, Chimdi Chuka Okosa, Kayode Fowobaje, Stephen Cook, Scott Lawrence, Ving Fai Chan, Augusto Azuara Blanco, Nathan Congdon, Tony Realini, STAGE Research Group

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To characterize treatment patterns for newly-diagnosed glaucoma in sub-Saharan Africa (SSA).

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

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, laser was recommended less, surgery more, and medications unchanged. Patient acceptance of medical therapy was 99.1%, laser 88.3%, and surgery 69.3%.

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.

Original languageEnglish
JournalJournal of Glaucoma
Early online date21 Jul 2023
Publication statusEarly online date - 21 Jul 2023

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