Prevalence of Normal-Tension Glaucoma in the Chinese Population: A Systematic Review and Meta-Analysis

Purpose To investigate the prevalence of normal-tension glaucoma (NTG) in the Chinese population through systematic review and meta-analysis. Design Systematic review and meta-analysis. Methods All Chinese population-based studies that reported the prevalence of NTG were identified. We searched PubMed and Chinese databases including Wanfang, China National Knowledge Infrastructure, and VIP for studies published before December 31, 2017. Random effects meta-analysis was conducted to estimate the pooled prevalence of NTG. Results Twelve studies were included in this review and meta-analysis, including 9 population-based studies and 3 studies from glaucoma clinics and managed care networks. The 9 population-based studies included a total of 30,892 subjects with 498 patients with primary open-angle glaucoma (POAG) and 354 patients with NTG. The prevalence of estimated NTG ranged from 0.36% to 1.98% and the percentage of NTG among POAG ranged from 51.43% to 83.58%. In the glaucoma clinic and managed care network studies, NTG prevalence was much lower. The overall pooled proportion of NTG among POAG in the Chinese population was 70.0% (95% confidence interval [CI] 62.0–77.0%). The overall pooled prevalence of POAG and NTG was 2.0% (95% CI 1.0–2.0%) and 1.0% (95% CI 1.0–1.0%), respectively. For the meta-regression of the NTG/POAG proportion, we found that age, gender, intraocular pressure, and China versus not China were not significantly associated with NTG/POAG prevalence, although the proportional prevalence decreased with increasing age category. Conclusions In this systematic review, we found that NTG is common among patients with POAG in the Chinese population. Our findings can help guide future glaucoma studies and public health guidelines in the Chinese population. To investigate the prevalence of normal-tension glaucoma (NTG) in the Chinese population through systematic review and meta-analysis. Systematic review and meta-analysis. All Chinese population-based studies that reported the prevalence of NTG were identified. We searched PubMed and Chinese databases including Wanfang, China National Knowledge Infrastructure, and VIP for studies published before December 31, 2017. Random effects meta-analysis was conducted to estimate the pooled prevalence of NTG. Twelve studies were included in this review and meta-analysis, including 9 population-based studies and 3 studies from glaucoma clinics and managed care networks. The 9 population-based studies included a total of 30,892 subjects with 498 patients with primary open-angle glaucoma (POAG) and 354 patients with NTG. The prevalence of estimated NTG ranged from 0.36% to 1.98% and the percentage of NTG among POAG ranged from 51.43% to 83.58%. In the glaucoma clinic and managed care network studies, NTG prevalence was much lower. The overall pooled proportion of NTG among POAG in the Chinese population was 70.0% (95% confidence interval [CI] 62.0–77.0%). The overall pooled prevalence of POAG and NTG was 2.0% (95% CI 1.0–2.0%) and 1.0% (95% CI 1.0–1.0%), respectively. For the meta-regression of the NTG/POAG proportion, we found that age, gender, intraocular pressure, and China versus not China were not significantly associated with NTG/POAG prevalence, although the proportional prevalence decreased with increasing age category. In this systematic review, we found that NTG is common among patients with POAG in the Chinese population. Our findings can help guide future glaucoma studies and public health guidelines in the Chinese population.