Tools to support data-driven identification and management of glaucoma in Sub-Saharan Africa

Early detection and appropriate management are important strategies to reduce the burden of glaucoma.<br><br>

Methods

The Severity Treatment and Acceptability of Glaucoma thErapy in Sub-Saharan Africa (STAGE) was a descriptive, multi-centre cross-sectional study which assessed the severity, treatment and acceptability of glaucoma therapy across Sub- Saharan Africa in newly diagnosed and follow-up-glaucoma-patients. In addition, an uncontrolled, experimental, before-and-after study in which non-ophthalmic DR graders were trained to screen for glaucoma using optic nerve photos in Vietnam was conducted.<br><br>Results: A total of 1214 newly diagnosed patients were enrolled on this study.

More than half presented with severe glaucoma in the worse eye, and one-third had severe glaucoma in both eyes. Physician and patient preference was medical therapy. Laser therapy was underutilized, and although 99% of the patients had access to trabeculectomy, physicians offered it to only 14% of patients at presentation.

In the diabetic retinopathy grading study, graders’ mean baseline score (33.3% ± 14.3%) improved significantly after training (55.8% ±12.6%, P Conclusion: The results of this work provide evidence that glaucoma is still a huge problem in SSA and that diabetic retinopathy (DR) graders can be trained to screen for glaucoma. This model may be key to the effective screening of glaucoma patients in LMICs.