ABSTRACT

This study was conducted to confirm the actual outbreak situation of primary open angle glaucoma and primary angle closure glaucoma using sample cohort data provided by National Health Insurance Service, and to investigate the risk factors involved in the development of glaucoma. Of the 1,033,624 subjects enrolled in the sample cohort data as of January 1, 2011, this study selected 1,009,687 subjects (505,466 male, 504,221 female) as of 2010, excluding those with the existing glaucoma diagnosis and newborns for the analysis, and determined the incidence of glaucoma for 5 years. This study selected 319,843 subjects (171,019 men and 148,824 women) for the analysis excluding subjects who do not have health check?up data or who have many missing important variables, and calculated risk factors using the Cox proportional hazard model. There were 4,907 subjects with occurrence of primary open angle glaucoma and 763 subjects with occurrence of primary angle closure glaucoma during the five years from 2011 to 2015, and the results of this study are as follows.
1. The five?year incidence of primary open angle glaucoma was 98.99 per 100,000 person?years, respectively 98.92 in men and 99.07 in women. The 5?year incidence of primary open angle glaucoma according to age, were found to be per 100,000 person?years, 0.93 persons under the age of 10, 10.36 persons in 10s, 26.78 persons in 20s, 47.37 persons in 30s, 78.93 persons in 40s, 147.04 persons in 50s, 294.47 persons in 60s, 418.66 persons in 70s, and 327.86 persons in those over 80 years of age. As for the 5?year incidence of primary open angle glaucoma, the highest incidence was in Busan area with 135.51 persons per 100,000 person?years, and the lowest incidence was in Ulsan area with 52.88 persons per 100,000 person?years.
2. The five?year incidence of primary angle closure glaucoma was 15.36 persons in all subjects per 100,000 person?years with 9.34 persons in males and 21.37 persons in females, demonstrating the higher incidence in females. The 5?year incidence of primary angle closure glaucoma according to age, were found to be per 100,000 person?years, 0 person under the age of 10, 0.29 persons in 10s, 2.06 persons in 20s, 3.15 persons in 30s, 5.95 persons in 40s, 19.08 persons in 50s, 69.03 persons in 60s, 80.62 persons in 70s, and 56.95 persons in over 80 years of age. The primary area where the primary angle closure glaucoma occurred the most was in Chungbuk province, and there were 26.56 persons per 100,000 person years in five years. The lowest incidence was 6.74 persons per 100,000 person?years in the Chungnam area.
3. The risk factors associated with primary open angle glaucoma were found to be age, hypertension, medical history of hypertension, medical history of diabetes mellitus, medical history of dyslipidemia, proteinuria, high body mass index, and large waist circumference. The risk factors associated with primary angle closure glaucoma were found to be age, females in sex, and vigorous exercise.
In the results of this study, glaucoma is found to be no longer a disease that only adults over 40 should manage but it seems that its proper inspection and management is required from at least 20 years of age. To this end, institutional apparatuses at the national level should be created, and at least the mandatory health screenings should include tests that can select glaucoma.