Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct:242:69-76.
doi: 10.1016/j.ajo.2022.05.023. Epub 2022 May 30.

Race and Ethnicity Differences in Disease Severity and Visual Field Progression Among Glaucoma Patients

Omar A Halawa  1 , Qingying Jin  2 , Louis R Pasquale  3 , Jae H Kang  4 , Alice C Lorch  1 , Lucia Sobrin  1 , Joan W Miller  1 , Yangjiani Li  5 , Mohammad Eslami  5 , Mengyu Wang  5 , Nazlee Zebardast  1 , Tobias Elze  6
Affiliations

Race and Ethnicity Differences in Disease Severity and Visual Field Progression Among Glaucoma Patients

Omar A Halawa et al. Am J Ophthalmol. 2022 Oct.

Abstract

Purpose: Investigate associations of race/ethnicity and preferred language with baseline glaucoma severity, VF test frequency and disease progression.

Design: Retrospective cohort study.

Methods: Patients receiving VF testing at a tertiary eyecare center between 1998 and 2020 with self-identified race, ethnicity and preferred language were included. Outcome measures were VF MD and age at first visit, VF test frequency, VF MD progression.

Results: Among 29,891 patients with VF measurements between 1998 and 2020, 55.1% were female, 71.0% self-identified as White/Caucasian, 14.0% as Black/African American, 7.4% as Asian and 6.4% as Hispanic, and 11.2% preferred a language other than English. Mean VF MD at presentation was worse among Black (-9.3±9.7 dB), Asian (-6.2±7.6 dB) and Hispanic (-8.3±9.3 dB) patients (vs. Whites [-5.5±7.3 dB, p<0.001] or non-Hispanics [-6.2±7.8 dB, p<0.001]). After controlling for age, gender and English proficiency, disparities in glaucoma severity at presentation were reduced, especially among Asian and Hispanic patients. Despite greater severity at presentation, Black patients had lower VF test frequency/person-years (1.07±0.53) compared to Whites (1.12±0.52, p=0.006) and worse VF MD progression (-0.43 dB/year, 95% CI -0.67 to -0.28, p<0.001). In contrast, Hispanics had a higher VF frequency vs. non-Hispanics (1.18±0.64 vs. 1.11±0.52, p<0.001), and no difference in VF progression (p=0.77).

Conclusions: Black, Asian and Hispanic patients had greater baseline severity vs. Whites. Unlike other groups, Black patients had a lower VF frequency vs. Whites and greater VF progression. Disparities in baseline severity were partially explained by English proficiency, especially for Asian and Hispanic patients.

Keywords: Glaucoma; glaucoma severity; racial disparities; visual field mean deviation; visual field testing.

PubMed Disclaimer

References

    1. Tielsch JM, Sommer A, Katz J, Royall RM, Quigley HA, Javitt J. Racial variations in the prevalence of primary open-angle glaucoma: The Baltimore Eye Survey. JAMA. 1991;266(3):369–374. - PubMed
    1. Ostermann J, Sloan FA, Herndon L, Lee PP. Racial differences in glaucoma care: the longitudinal pattern of care. Arch Ophthalmol. 2005;123(12):1693–1698. - PubMed
    1. Varma R, Ying-Lai M, Francis BA, et al. Prevalence of open-angle glaucoma and ocular hypertension in Latinos: the Los Angeles Latino Eye Study. Ophthalmology. 2004;111(8):1439–1448. - PubMed
    1. Stein JD, Kim DS, Niziol LM, et al. Differences in rates of glaucoma among Asian Americans compared with other races and among individuals of different Asian ethnicities. Ophthalmology. 2011;118(6):1031–1037. - PMC - PubMed
    1. Glynn RJ, Gurwitz JH, Bohn RL, Monane M, Choodnovskiy I, Avorn J. Old age and race as determinants of initiation of glaucoma therapy. Am J Epidemiol.138(6):395–406. - PubMed

Publication types