Liwan Eye Study: the Fourth Follow-up

Primary angle-closure glaucoma (PACG) is potentially a devastating disease, responsible for half of glaucoma-related blindness worldwide, especially in East Asia. Primary angle-closure suspect (PACS), which is characterized by appositional angle closure, is the earliest stage of primary angle closure diseases and can finally progress to PACG. Thus, identifying PACS eyes at risk of angle closure is crucial for its management. However, the natural history of progression from PACS to PACG and its prediction models are still limited in long-term longitudinal studies. Meanwhile, visual impairment poses a significant global public health burden along with the accelerating trend of aging, it is imperative to further evaluate the visual impairment among the elderly population. The Liwan Eye Study was a population-based study initiated in 2003. The decision to select Liwan District for the survey was taken because of its stable, older population and a socioeconomic profile representative of Guangzhou as a whole. At baseline, 1405 eligible subjects aged 50 years and older completed a comprehensive eye examination and a questionnaire interview regarding education, income, hypertension and diabetes mellitus. To improve the monitoring of PACS and prevent vision loss associated with PACG, the purposes of this observational cohort study are to investigate the 20-year incidence of PACG in Chinese population aged over 50 years, develop prediction models that include eye characteristics, demographic features, ocular imaging characteristics, and genetic factors for the long-term risk of progression from PACS to PACG. Moreover, we aim to investigate the 20-year change in visual impairment and associated factors.