The British journal of ophthalmology
September 17, 2026 · via Europe PMC
Incidence patterns and genetic validation of primary glaucoma subtypes among 1 million adults in China and the UK.
Li C, Wang B, Walters RG, +19 more, Du H.
AI summary — for doctors, generated from the abstract only
A large population study of over 1 million adults in China and the UK found that most recorded glaucoma cases lack subtype specification, and genetic evidence suggests the composition of these unspecified cases differs between the two populations.
What was studied
A study of incident primary glaucoma using linked inpatient records from the China Kadoorie Biobank (n=512,504) and UK Biobank (n=492,329), defining POAG, PACG, and unspecified glaucoma via cohort-specific algorithms, and using polygenic risk scores (including a new East Asian PACG genome-wide association meta-analysis) to infer the likely subtype composition of unspecified glaucoma cases.
Key findings
- Over 12 years follow-up, 1658 primary glaucoma cases were identified in the China cohort and 7643 in the UK cohort; more than 68% of cases lacked subtype specification.
- Incidence increased with age; PACG incidence was twofold higher in women in both cohorts, as was unspecified glaucoma incidence in the China cohort.
- In the UK cohort, POAG incidence was fivefold higher among Black than White participants, with a similar but attenuated pattern for unspecified glaucoma.
- Polygenic risk score analyses indicated unspecified glaucoma closely resembled PACG genetically in the China cohort but was more heterogeneous in the UK cohort.
Clinical relevance
The findings suggest that population-level glaucoma data without subtype detail should be interpreted with caution, as the underlying mix of POAG and PACG likely differs by population, which may be relevant to researchers and clinicians using such registry data.
Who should care
Limitations
The study relied on cohort-specific phenotyping algorithms and inpatient records, and subtype inference for unspecified cases was based on genetic association rather than direct clinical confirmation.
Most registry-recorded glaucoma cases lack subtype detail, and genetic data show the true subtype mix differs meaningfully between Chinese and UK populations.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background/aims
Primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) are distinct diseases, yet many glaucoma cases in population-based datasets lack subtype specification. We assessed incidence patterns of glaucoma subtypes in China and the UK and used genetic evidence to infer the likely subtype composition of cases recorded as unspecified glaucoma.
Methods
Incident primary glaucoma was identified from linked inpatient records in the prospective China Kadoorie Biobank (CKB; n=512 504) and UK Biobank (UKB; n=492 329) studies. Cohort-specific phenotyping algorithms defined POAG, PACG and unspecified glaucoma. Adjusted incidence rates were estimated by direct standardisation. To support subtype inference, polygenic risk scores (PRSs) were constructed using ancestry-specific genome-wide association studies, including a new East Asian PACG meta-analysis, and tested for association with glaucoma phenotypes using multivariable logistic regression.
Results
Over 12 years of follow-up, 1658 primary glaucoma cases were identified in CKB and 7643 in UKB. Most (>68%) cases lacked subtype specification. Incidence increased with age and was twofold higher among women for PACG in both cohorts and for unspecified glaucoma in CKB. In UKB, POAG incidence was fivefold higher among Black than White participants, with a similar but attenuated pattern for unspecified glaucoma. PRS analyses indicated that unspecified glaucoma closely aligned with PACG in CKB but was more heterogeneous in UKB.
Conclusion
Healthcare-recorded incidence patterns for POAG and PACG were consistent with established demographic risk factors, whereas unspecified glaucoma showed differences in subtype composition between populations. Integrating epidemiological and genetic evidence improves interpretation of glaucoma phenotypes when detailed clinical information is unavailable.
DOI
10.1136/bjo-2026-330795
PMID
42754369
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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