Targeting at risk relatives of glaucoma patients for early diagnosis and treatment
The TARRGET project (Targeting At Risk Relatives of Glaucoma patients for Early diagnosis and Treatment) is nearing completion of the pilot study phase. In collaboration with Glaucoma Australia, 100 participants (index cases) with advanced glaucoma from the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG) have been contacted and we are now in the process of completing collection of clinical information from their immediate relatives in relation to their glaucoma status.
Several previous studies have reported that immediate relatives of glaucoma patients have an increased risk of developing glaucoma: approximately one in four first-degree relatives (parents, siblings and children) have been reported to have glaucoma or suspicion of glaucoma. However, there are no published reports as to whether the risk could be higher when the index case has reached the advanced stage of the disease, which is when the disease has progressed to involve the central vision. The TARRGET project has only selected index cases with advanced glaucoma and hypothesised that the rates of glaucoma/glaucoma suspects among the relatives would be higher due to the severity of glaucoma among the index cases.
Relatives have assisted Glaucoma Australia and the ANZRAG by attending clinics at Flinders Medical Centre and the Repatriation General Hospital in Adelaide to be seen by one of the TARRGET clinicians for a full glaucoma screening. When relatives have been unable to attend one of these appointments, they have visited a local optometrist to have a form completed for us. Our aim is to confirm glaucoma status for as many first-degree relatives as possible.
A total of 119 first-degree relatives from 100 families have been screened. Over half (55%) of those relatives (our participants) were diagnosed as glaucoma or glaucoma suspect, including 28% who were newly diagnosed as a result of our project (see table below). Our results indicate that the risk of developing glaucoma among immediate relatives is higher when a person in the family has reached severe glaucoma and show the importance of patient education and screening for family members of individuals with advanced glaucoma. In addition, it highlights the lack of awareness about the disease as one third of the first-degree relatives of glaucoma patients had never had their eyes checked before the study.
It is well known that glaucoma can develop without any noticeable symptoms in the early stages. The damage it causes cannot be reversed, so early detection is paramount as it presents the best chance to slow the progression of the disease and prevent vision loss. The TARRGET study aims to show that comprehensive screening of immediate relatives of people with glaucoma could aid in early detection and prevent vision loss. We hope to advocate for such screening programs to be readily available in Australia.
|1st Degree Relatives Screened||119|
|New glaucoma diagnosis||7 (5.8%)|
|Previous glaucoma diagnosis confirmed||22 (18.5%)|
|Total individuals with glaucoma||29 (24.3%)|
|New glaucoma suspect diagnosis||26 (21.8%)|
|Previous glaucoma suspect diagnosis confirmed||11 (9.2%)|
|Total glaucoma suspects||37 (31.1%)|
|No glaucoma||52 (43.7 %)|
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