Objective  To estimate of the prevalence of primary glaucoma in mainland China and to quantify the association with age, gender, and region.

Methods  Population-based studies that reported the prevalence of primary open-angle glaucoma (POAG) or/and primary angle-closure glaucoma (PACG) among adult populations in mainland China were identified through systematic searches. Fourteen articles providing 12 population-based studies were included. The overall pooled prevalence estimates were calculated using a random effects model. A logistic meta-regression was used to model the associations between the odds ratio and 95% confidence interval (CI) of primary glaucoma and age, gender, and region.

Results  The overall pooled prevalence of POAG was 0.7% (95% CI, 0.4%-1.2%), and PACG was found in 1.4% (95% CI, 1.0%-1.7%). The odds ratio per decade increase in age was 1.68 (95% CI, 1.12-2.52) for POAG, and 2.11 (95% CI, 1.72-2.60) for PACG. The odds ratio of POAG prevalence was 0.65 (95% CI, 0.26-1.62) between men and women. Chinese women were 1.75 (95% CI, 1.20-2.56) times more likely than men to have PACG. The odds ratios between Western China and East China were 0.37 (95% CI, 0.10-1.35) for POAG, and 1.06 (95% CI, 0.63-1.76) for PACG.

Conclusions  Primary angle-closure glaucoma was approximately double prevalence than primary open-angle glaucoma in adult Chinese. The rate of change of PACG prevalence with age increases more rapidly than that of POAG. The prevalence of POAG was similar between men and women. However, PACG is more common in women than in men.