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Abstract #127820 Published in IGR 25-3
Impact of social determinants of health and medication burden on quality of life and disease severity in glaucoma
Shiromani S; Bui J; Nguyen G; Reed DM; Kedar S; Ghate DCanadian Journal of Ophthalmology 2025; 60: 368-377
BACKGROUND: The interplay between social determinants of health (SDH), peripheral field loss in glaucoma, frailty, and medication burden impacts treatment outcomes and quality of life (QoL). OBJECTIVE: To evaluate the interaction between SDH, glaucoma characteristics, frailty, QoL in an Atlanta cohort with peripheral field loss. METHODS: Cross-sectional study including primary glaucoma subjects satisfying inclusion criteria. Electronic medical records provided age, zip code (for area deprivation, crime rate, poverty), visual acuity, binocular Visual Field Index (OU VFI), and number of medications. Glaucoma severity was classified by OU VFI: mild (>95%), mild to moderate (81-95%), moderate to severe (50-80%), and severe (<50%). Subjects completed surveys on demographics (race, sex, income, occupation, education), QoL (Short Form-36 and National Eye Institute-Visual Function Questionnaires), and frailty (FRAIL questionnaire). RESULTS: Among 139 subjects (mean age 67 ± 11 years), glaucoma severity was greater in Black versus White individuals (OU VFI: 72 ± 25% vs 83 ± 19%; p = 0.01), and in men versus women (OU VFI: 72 ± 26% vs 83 ± 19%; p = 0.004). Severity correlated with visual acuity (ANOVA: p < 0.001); QoL (NEI-VFQ scores: r = 0.6; p < 0.001). Neither zip code indices nor frailty were associated with severity/QoL. Multivariate modeling identified glaucoma severity as the sole predictor of QoL; medication burden had no independent impact. CONCLUSIONS: Black race, male sex, visual acuity, and medication burden were associated with glaucoma severity. QoL was associated solely with glaucoma severity; medication burden had no independent impact. These findings inform glaucoma management strategies in Atlanta's diverse community.
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, United States.
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