The prevalence of primary angle closure glaucoma in adult Asians: a systematic review and meta-analysis

PLoS One. 2014 Jul 24;9(7):e103222. doi: 10.1371/journal.pone.0103222. eCollection 2014.


Background: Primary angle closure glaucoma (PACG) is higher in Asians than Europeans and Africans, with over 80% of PACG worldwide in Asia. Previous estimates of PACG were based largely on early studies, mostly using inappropriate case definitions. Therefore, we did a systematic review and meta-analysis to estimate the prevalence of PACG in adult Asian populations and to quantify its association with age, gender, and region.

Methods: All primary reports of population-based studies that reported the prevalence of PACG in adult Asian populations were identified. PACG case definition was compatible with the ISGEO definition. Twenty-nine population-based studies were included. The overall pooled prevalence estimates were calculated using a random effect model, and ethnicity-, age- and gender-specific pooled prevalence estimates were also calculated.

Results: The overall pooled prevalence of PACG in those of adult Asians was 0.75% (95% CI, 0.58, 0.96). Ethnicity-specific pooled prevalence estimates were 0.97% (0.22, 4.27) in Middle East group, 0.66% (0.23, 1.86) in South East Asia group, 0.46% (0.32, 0.64) in India group, 1.10% (0.85, 1.44) in China group, and 1.19% (0.35, 3.98) in Japan group, respectively. Age-specific prevalence was 0.21% (0.12, 0.37) for those 40-49 years, 0.54% (0.34, 0.85) for those 50-59 years, 1.26% (0.93, 1.71) for those 60-69 years, and 2.32% (1.74, 3.08) for those 70 years or above. The overall female to male ratio of the PACG prevalence was 1.51∶1 (95% CI 1.01, 2.28).

Conclusions: PACG affects approximately 0.75% adult Asians, increasing double per decade, and 60% of cases being female. The prevalence rates vary greatly by ethnic region.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asia / epidemiology
  • Asia / ethnology
  • Asians / statistics & numerical data*
  • Female
  • Glaucoma, Angle-Closure / epidemiology*
  • Glaucoma, Angle-Closure / ethnology
  • Humans
  • Male
  • Middle Aged
  • Prevalence

Grant support

This work was supported by Shanghai Rising-Star Program (Grant No. 12QA1404600), Shanghai Municipal Natural Science Foundation (Grant No. 10ZR1439300), and National Natural Science Foundation of China (Grant No. 81000374 and 81170874). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.