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S. Bagai, P.P. Chen, R.C. Mudumbai; Comparison Of Glaucomatous Visual Impairment On Initial Examination Between Ethnic Groups At An Urban County Hospital . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3422.
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Differences exist between races in glaucoma etiology, severity and blindness. In this study we compare the presenting characteristics of patients with glaucomatous visual impairment from different ethnic backgrounds examined at a tertiary care urban county hospital.
Retrospective chart review. Glaucomas were classified into the major categories of Chronic Open Angle Glaucoma (COAG), Chronic Angle Closure Glaucoma (CACG), Acute Angle Closure Glaucoma (AACG), Neovascular Glaucoma (NG) and Normal Tension Glaucoma (NTG). The diagnosis of glaucoma included optic nerve appearance and/or visual field defects consistent with glaucoma irrespective of intraocular pressure, or patients who otherwise had intraocular pressure greater than 30 mmHg. Abnormal optic nerve appearance included a cup–to–disc (C/D) ratio of greater than 0.5, C/D asymmetry of 0.2 between optic nerves and other typical findings including disc hemorrhage, focal thinning of the rim or notches. Blindness was defined as visual acuity of 20/200 or worse, or continuous constriction on threshold perimetry to values less than 10 dB within the central 20 degrees of vision. Patients with ocular or neurological disease that could affect visual acuity or field were excluded except for when it led to blindness from neovascular glaucoma. Patients with consistently unreliable visual fields were also excluded.
115 patients were identified, 36 patients were excluded and 79 patients were analyzed . Four major ethnic populations were identified and their initial glaucoma features are as follows:
All ethnic groups had quite significant levels of optic nerve damage from glaucoma. Intraocular pressure was highest for AF. Average visual field damage was greatest for AF and SEA. Blindness was found in a significant minority of all groups but was greatest among AA. Vision loss from glaucoma remains a significant problem among major ethnic groups obtaining care at our urban county hospital.
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