Comparison of the Clinical Profile of Patients with Glaucoma Between Private and Government Clinics in the Philippines
Edgar Felipe U. Leuenberger, MD, DPBO,1 James Paul S. Gomez, MD, DPBO,1 Robert Edward T. Ang, MD, DPBO,1 Maria Imelda Yap-Veloso, MD, DPBO,1 Joseph Anthony J. Tumbocon, MD, DPBO,2 Jose Ma. D. Martinez, MD, DPBO,3 John Mark S. De Leon, MD, DPBO,3 Nilo Vincent FlorCruz, MD, DPBO,4 Rainier Victor A. Covar, MD, DPBO,4 Irene R. Felarca, MD, DPBO,1 Denise Polly Chao-Po, MD, DPBO,2 Shalam Siao-Mariano, MD, DPBO,3 Marie Joan Therese D. Balgos, MD, DPBO,4 Noel D. Atienza, MD, DPBO2
For the Philippine Glaucoma Society
1Asian Eye Institute, Makati City, Philippines
2Eye Institute, St. Luke’s Medical Center, Quezon City, Philippines
3The Department of Health Eye Center, East Avenue Medical Center, Quezon City, Philippines
4Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila, Philippines
Correspondence: Edgar Felipe U. Leuenberger, MD, DPBO
Asian Eye Institute
9F Phinma Plaza, Rockwell Center, Makati City, Philippines
Disclosure: This study was funded by an unrestricted grant from Santen Pharmaceutical Co. Ltd. Supplemental support was received from the Philippine Glaucoma Society and the Asian Eye Institute. The corresponding author and study team independently conducted all phases of the research and assume full accountability for its content.
ABSTRACT
Objective: To describe the demographic and clinical characteristics of patients with glaucoma managed at private and government institutions in the Philippines between 2009 and 2014.
Methods: A research team from two private and two government institutions in the Philippines reviewed the case records of 1246 patients seen who met the following criteria: intraocular pressure of >21 mmHg, optic nerve and nerve fiber layer abnormalities, and visual field defects. For bilateral cases, we selected the eye with worse glaucoma parameters.
Results: There were 600 and 646 patients in the private and government groups (mean age at presentation, 60.51 and 55.88 years), respectively, with the majority being Filipino (91%). Patients with visual acuity (VA) of 20/20 to 20/40 were more frequently observed in private centers (58.7% vs. 41.3%), while a VA worse than counting fingers was more frequently observed in government centers (66.1% vs. 33.9%). Within-group analysis showed that primary angle-closure glaucoma was the most frequent glaucoma subtype in both private (27.3%) and government institutions (37.8%). In between-group analysis showed the following to be more common in private than government centers: primary open-angle glaucoma (61.3% vs. 38.7%), normal-tension glaucoma (63.9% vs. 36.1%), ocular hypertension (92.3% vs. 7.7%), and glaucoma suspects (80.4% vs. 19.6%) while government institutions registered a larger number of primary angle-closure glaucoma (59.8% vs. 40.2%) and secondary glaucoma (70.3% vs. 29.7%) cases. Medical treatment using a single drug and multiple drugs was employed for 245 (23%) and 825 (77%) patients, respectively. Within-group analysis showed that laser iridotomy and trabeculectomy were the most commonly performed laser and surgical procedures in both institution types.
Conclusion: There is a contrasting profile of glaucoma between clinical institutions in the Philippines with open-angle glaucoma being more predominant in private centers while closed-angle glaucoma and secondary glaucoma being more frequent in government centers. Our findings may provide important preliminary information that can aid future health studies or training programs.
Keywords: Glaucoma, epidemiology, private institutions, government institutions, Philippines