Latin American ethnicity linked to risk for open-angle glaucoma
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New data revealed individuals of Latin American descent have unique differences in ocular anatomy and physiology that may correlate with an increased risk for open-angle glaucoma.
“Persons of Latin American descent (LAD) ... currently represent the largest minority group in the United States and remain understudied despite being predicted to become the largest demographic affected by glaucoma by 2050,” Patrick Wurster, BS, from the Indiana University School of Medicine, and colleagues wrote in the Journal of Glaucoma.
The researchers performed a literature review of common risk factors for glaucoma — including IOP, ocular anatomic characteristics, and age and race — with comparisons between persons of LAD, African descent and European descent in the U.S.
Results showed that persons of LAD with African ancestry had significantly higher rates of increased IOP, especially among those with hypertensive status and African ancestry.
Both increased baseline IOP per 1.18 mm Hg and greater variability of IOP between visits were general risk factors for OAG in persons of LAD in the U.S.
“Understanding IOP risk factors within this population may provide clinicians greater insight into screening for and managing glaucoma in persons of LAD,” the researchers wrote.
Other unique factors among persons of LAD that may play a role in the risk for or progression of OAG included scleral tensile strain, longer axial length, thin corneas and corneal hysteresis.
Persons of LAD in the U.S. are also more likely to have diabetes and higher systolic blood pressure compared with individuals of European descent.
The researchers highlighted that telemedicine programs in underserved areas may be a way to increase the number of people screened for glaucoma. Artificial intelligence algorithms could be used to increase glaucoma detection by identifying correlated functional, structural and genetic factors.
“Underreporting of glaucoma diagnosis and underutilization of medical and surgical resources for prevention of progression should be important clinical considerations in the study and management of glaucoma in persons of LAD in the United States,” Wurster and colleagues concluded. – by Talitha Bennett
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Mark Eltis, OD, FAAO
Persons of LAD are projected to become the largest group affected by glaucoma in the U.S. by 2050. Despite this, few studies have targeted the LAD population. Persons of LAD are not a homogenous group, yet valuable information is missing that could help diagnose and treat this patient population. Specific risk factors involving the structural, vascular and related medical conditions affecting the LAD population are important areas of research focus.
The one-size-fits-all approach to health care is outdated. Today’s doctor must recognize each patient as an individual and identify his or her particular risk factors. In our multicultural society we must be very aware of potential differences in glaucoma diagnosis and management for various groups. While the information may be clinically relevant, particular care and sensitivity must be exercised when asking about a patient’s background.
As we wait for more literature to help tailor our use of modern testing to each population (such as OCT normative data and progression patterns, corneal hysteresis and blood flow analysis) we should educate patients on known risk factors and strive towards an individualized approach to health care.
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