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T.R. Stelmack, T. Barton, A. Lorenz; POAG in Younger African American Males - A More Agressive Disease? . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4365.
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Purpose: The literature has suggested that POAG is more prevalent and maybe more aggressive in the African American populations. The purpose of this study was to review records of younger African American males with POAG at the VA Chicago Healthcare System WS Division to describe the initial presentation and course of glaucoma. Methods: Records were reviewed of those African American males with OAG who were diagnosed younger that age 55 and follow by the WS eye clinic during the past 5 years. All secondary OAG was excluded. A ‘date of diagnosis’ matched group older than 55 served as controls. Results: 50 patients under age 55 years with a mean age of 46.7 (range 34-55) were identified with OAG. A total of 7 were excluded for secondary OAG or OHTN. Of the remaining 43 patients CD the mean horizontal and vertical ratio was 0.77 (0.30 – 1.0) and 0.78 (.3-1.0) respectively. The IOP ranged from 11 – 54 mm Hg. As of last visit the group was taking an average of 2.5 medications (range 1-5) and had been prescribed a mean of 3.8 (range 1-9). The total number of procedures performed from this group was 23 (mean .53). Of the 86 eyes evaluated in this series 32 had full VF, 21 had nasal steps, 7 had paracentral / arcuate scotomas, 1 Bjerrum defect, 7 ring scotomas / central islands, 8 general constriction. 10 had not VF information of which 5 were NLP. Conclusions: It would be expected that early glaucoma would be controlled with one or two medications. Patients in the under 55-year-old sample were taking an average of 2.5 meds and already had undergone an average of 5.3 procedures suggesting they had already reached maximum tolerated medical therapy greater in number than the matched group. Although further study is needed these results suggest a more advanced presentation of glaucoma in these young AAM that would otherwise be expected.
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