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Hispanics have higher prevalence of glaucoma than previously thought

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BALTIMORE — The prevalence of open-angle glaucoma in Hispanics was found to be higher than previously thought in a study conducted in the southwestern United States.

The rate of glaucoma in U.S. Hispanics was between the rates previously found in white and black people. The prevalence in Hispanics increased more rapidly with age than in other ethnic groups, according to the study, conducted by researchers from Johns Hopkins.

Screening for glaucoma in this population using an intraocular pressure (IOP) criterion higher than 22 mm Hg would miss about 80% of the open-angle glaucoma cases, the study authors add.

Researchers examined 4,774 Hispanics living in the Nogales and Tucson, Ariz., areas. A total of 94 people were defined as having open-angle glaucoma (OAG). Age-specific OAG prevalence increased from 0.5% in people between the ages of 41 and 49 to almost 13% in people at least 80 years old. The proportion of men and women affected did not differ significantly with age. Applanation IOP for healthy people was 15.6 mm Hg; eyes with glaucoma had a mean IOP of 18.5 mm Hg.

Of the 94 glaucoma patients identified, 62% were unaware of their diagnosis before the study. The authors believe socioeconomic factors contribute to the high rate of undiagnosed OAG. (White and black people in the United States and other developed countries have an undiagnosed glaucoma rate of about 50%.)

"The use of IOP as a method of screening for glaucoma would clearly fail," the study authors wrote. "The 97.5 percentile value for IOP herein in the eye with a higher pressure is 22 mm Hg; however, only a few of those with OAG would be identified by an IOP higher than this criterion in the eye with a higher pressure." The low rate of diagnosis for this population may be a reflection of the ophthalmologists' reliance upon IOP measurement alone instead of on optic disc and visual field exams, the study authors suggest.

The study is published in Archives of Ophthalmology.