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Abstract #69218 Published in IGR 18-1
Risk Factors Associated with Progression to Blindness from Primary Open-Angle Glaucoma in an African-American Population
Pleet A; Sulewski M; Salowe RJ; Fertig R; Salinas J; Rhodes A; Merritt Iii W; Natesh V; Huang J; Gudiseva HV; Collins DW; Chavali VR; Tapino P; Lehman A; Regina-Gigiliotti M; Miller-Ellis E; Sankar P; Ying GS; O'Brien JMOphthalmic Epidemiology 2016; 23: 248-256
See also comment(s) by David Friedman •
PURPOSE: To determine the risk factors associated with progression to blindness from primary open-angle glaucoma (POAG) in an African-American population. METHODS: This study examined 2119 patients enrolled in the Primary Open-Angle African-American Glaucoma Genetics (POAAGG) study. A total of 59 eyes were identified as legally blind as a result of POAG (cases) and were age-and sex-matched to 59 non-blind eyes with glaucoma (controls). Chart reviews were performed to record known and suspected risk factors. RESULTS: Cases were diagnosed with POAG at an earlier age than controls (p = 0.005). Of the 59 eyes of cases, 16 eyes (27.1%) presented with blindness at diagnosis. Cases had worse visual acuity (VA) at diagnosis (p < 0.0001), with VA worse than 20/40 conferring a 27 times higher risk of progression to blindness (p = 0.0005). Blind eyes also demonstrated more visual field defects (p = 0.01), higher pre-treatment intraocular pressure (IOP; p < 0.0001), and higher cup-to-disc ratio (p = 0.006) at diagnosis. IOP was less controlled in cases, and those with IOP ≥21 mmHg at more than 20% of follow-up visits were 73 times more likely to become blind (p < 0.0001). Cases missed a greater number of appointments per year (p = 0.003) and had non-adherence issues noted in their charts more often than controls (p = 0.03). However, other compliance data did not significantly differ between groups. CONCLUSION: Access to care, initial VA worse than 20/40, and poor control of IOP were the major risk factors associated with blindness from POAG. Future studies should examine earlier, more effective approaches to glaucoma screening as well as the role of genetics in these significantly younger patients who progress to blindness.
a Scheie Eye Institute , University of Pennsylvania , Philadelphia , PA , USA.
Full articleClassification:
1.5 Glaucomas as cause of blindness (Part of: 1 General aspects)
9.2.2 Other risk factors for glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
6.20 Progression (Part of: 6 Clinical examination methods)
