Study highlights association between socioeconomic status and glaucoma-related blindness
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African American ethnicity, single marital status, lower income and less education, as well as male gender and age, were identified in a study as risk factors associated with blindness at presentation among patients with glaucoma.
“Our results highlight disparities in health care outcomes and suggest that public health outreach for vulnerable communities may reduce differential outcomes in blindness,” Samuel I. Berchuck, PhD, said at the virtual Association for Research in Vision and Ophthalmology meeting.
The study was conducted at Duke Eye Center using the Duke Glaucoma Registry, containing the electronic health records of more than 100,000 patients seen at Duke and satellites. The aim was to identify risk factors for blindness from glaucoma at first presentation to a tertiary clinic. Blindness was defined according to the legal definition, that is, central visual acuity of 20/200 or less with correction, or visual field of 20° or less in the better eye. Risk factors considered in the analysis were gender, race, marital status, age, income and education. Two clinical variables — baseline IOP and diabetes history — were included.
“Of the 7,621 patients with glaucoma who met the inclusion criteria, 4% were legally blind at presentation. Male gender, African American ethnicity, single marital status, older age, lower income and lower education were all risk factors. These associations remained significant in a multivariable regression,” Berchuck said.
He said that glaucoma is a leading cause of irreversible blindness, accounting for 12% of all cases of blindness worldwide. Within 15 years of diagnosis of open-angle glaucoma, 15% of patients progress to blindness in at least one eye, while 6.4% become blind in both eyes. The results of this study confirm the relationship between lower socioeconomic status and higher blindness rate.
“The next step is to look at disparities associated with progression to blindness,” Berchuck said.
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Berchuck SI, et al. Identifying risk factors for blindness from glaucoma at first presentation to a tertiary clinic. Presented at: Association for Research in Vision and Ophthalmology annual meeting; May 1- 7, 2020 (virtual meeting).
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