Black Individuals Have Higher Risk of Advanced Vision Loss After Primary Open Angle Glaucoma Diagnosis

Black individuals have a dramatically higher risk of advanced vision loss after a new diagnosis of primary open angle glaucoma (POAG) compared to white individuals, according to results of a study from New York Eye and Ear (NYEE) Infirmary of Mount Sinai. The findings, published in Translational Vision Science and Technology, show that African heritage is an independent risk factor for this decline in vision and should prompt more eye screening for early glaucoma detection.

This study is the first to use an artificial intelligence algorithm to break down visual field loss in new-onset glaucoma cases among population groups in the United States.

“This study has tremendous implications for glaucoma screening of Blacks, who we already knew were a population at increased risk of glaucoma,” Louis Pasquale, MD, FARVO, deputy chair for Ophthalmology Research at the Icahn School of Medicine at Mount Sinai and director of the NYEE Eye and Vision Research Institute, said in a statement. “Screening earlier in life could significantly increase the chance of detecting glaucoma and slowing down progression before it reaches one of the advanced patterns shown in our research.”

Investigators analyzed nearly 210,000 individuals from 3 population-based databases of nurses and health care professionals from the Nurses’ Health Study, enrolled between either 1980 and 2018 or 1989 and 2019, and the Health Professionals Follow-up Study, enrolled between 1986 and 2018.

Individuals were over 40 years of age and their data were collected during comprehensive eye exams. At the start of the study, none of the individuals had glaucoma at baseline and were followed biennially. During this time, they provided updated information on their lifestyle, diet, and medical status, including glaucoma diagnosis. Within the study group, 1946 individuals developed glaucoma.

The investigators analyzed their earliest record of visual field loss using archetype analysis. The algorithm identified 14 archetypes: 4 that represented advanced loss patterns, 9 that represented early loss, and 1 that represented no visual field loss.

Black individuals made up 1.3% of the study, but still had a nearly 2-fold increased risk of early visual field loss and a 6-fold higher risk for advanced field loss archetypes, compared to white individuals. Asian individuals, who made up about 1.2% of the individuals, had nearly a 2-fold higher risk of early visual field loss compared to white individuals, but did not have higher rates of advanced patterns of visual field loss.

Hispanic individuals made up 1.1% of the study and did not have any increased risk of any archetypes compared to white individuals. The study did show that they were at risk of an archetype showing initial loss near the center of their visual field.

Investigators said that the next steps are to figure out the specific risk factor for the different patterns of visual loss seen in individuals with glaucoma, which included genetic and environmental factors.

Reference

Black patients found six times more likely to have advanced vision loss after glaucoma diagnosis than white patients. News release. EurekAlert. July 25, 2022. Accessed July 25, 2022. https://www.eurekalert.org/news-releases/959248