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Glaucoma more common in those who are older, African American, poorer
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Researchers found a higher prevalence of glaucoma in people who are older, are of black race and have lower income levels and identified a novel association between triglyceride levels and glaucoma, according to a study in Investigative Ophthalmology and Visual Science.
Participants with glaucoma were found to be older (68.1 years vs. 56.4 years) and more likely to be African American.
In addition, they were more likely to have education less than high school (25.1% vs. 18.1%), to have diabetes (23.1% vs. 10.8%), to have central obesity (72.45% vs. 60.7%), to have systolic hypertension of at least 140 mm Hg (30.3% vs. 20.1%) and to have diastolic hypotension up to 60 mm Hg (30.3% vs. 13.9%), according to researchers.
They were less likely to be current smokers.
Researchers found that diabetes of 1 to 9 years duration was significantly associated with glaucoma, but diabetes of greater than or equal to 10 years duration was not.
“Older age and black race, both of which are nonmodifiable, have been identified as strong risk factors in multiple studies, and our findings confirm these results,” the researchers wrote. – by Abigail Sutton
Disclosure: Ko reported no relevant financial disclosures. For a full list of remaining authors’ financial disclosures, please see the full study.
Perspective
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Blair Lonsberry, OD, FAAO
Participants age 40 and older from the National Health and Nutrition Examination Survey underwent questionnaires, physical examination, laboratory tests and vision tests including fundus imaging.
Using optic nerve appearance on fundus photographs alone, older age, black race and poverty were significantly associated with glaucoma.
Diabetes appeared to be significantly associated with glaucoma if considered alone; however, when triglyceride levels were included the association with diabetes was no longer statistically significant. Interestingly, triglyceride levels were found to be inversely associated with glaucoma.
The strengths of the study include its representative population-based sampling and standardized methodology. However, there are several limitations, as glaucoma was solely based on nonstereoscopic fundus images, and only those with cup-to-disc ratio of greater than 0.6 were considered in the analysis.
Glaucoma diagnosis is a challenge, and one can reasonably doubt a diagnosis made on only one set of nonstereo disc photographs alone. That said, the findings that black race and age are associated with glaucoma are hardly earth shattering.
However, the finding that triglyceride levels of higher than 200 mg/dL were inversely associated with glaucoma prevalence is very interesting and deserving of further investigation. This finding, should it be confirmed, has implications for research into the pathophysiology of glaucoma as well as possible glaucoma treatments.
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