June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Quantifying Factors Related to Severe Vision Loss in African Americans with Primary Open-Angle Glaucoma
Author Affiliations & Notes
  • Allison Rhodes
    Department of Ophthalmology , University of Pennsylvania, Scheie Eye Institute , Philadelphia, Pennsylvania, United States
  • Qi J Cui
    Department of Ophthalmology , University of Pennsylvania, Scheie Eye Institute , Philadelphia, Pennsylvania, United States
  • Maxwell Pistilli
    Department of Ophthalmology , University of Pennsylvania, Center for Preventive Ophthalmology and Biostatistics , Philadelphia , Pennsylvania, United States
  • Ebenezer Daniel
    Department of Ophthalmology , University of Pennsylvania, Center for Preventive Ophthalmology and Biostatistics , Philadelphia , Pennsylvania, United States
  • PRITHVI SANKAR
    Department of Ophthalmology , University of Pennsylvania, Scheie Eye Institute , Philadelphia, Pennsylvania, United States
  • Eydie G Miller-Ellis
    Department of Ophthalmology , University of Pennsylvania, Scheie Eye Institute , Philadelphia, Pennsylvania, United States
  • Victoria Addis
    Department of Ophthalmology , University of Pennsylvania, Scheie Eye Institute , Philadelphia, Pennsylvania, United States
  • Amanda Lehman
    Department of Ophthalmology , University of Pennsylvania, Scheie Eye Institute , Philadelphia, Pennsylvania, United States
  • Maureen G Maguire
    Department of Ophthalmology , University of Pennsylvania, Center for Preventive Ophthalmology and Biostatistics , Philadelphia , Pennsylvania, United States
  • Joan M O'Brien
    Department of Ophthalmology , University of Pennsylvania, Scheie Eye Institute , Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Allison Rhodes, None; Qi Cui, None; Maxwell Pistilli, None; Ebenezer Daniel, None; PRITHVI SANKAR, None; Eydie Miller-Ellis, None; Victoria Addis, None; Amanda Lehman, None; Maureen Maguire, None; Joan O'Brien, None
  • Footnotes
    Support  Financial support: This work was supported by the National Eye Institute, Bethesda, Maryland (grant #1RO1EY023557-01) and the Department of Ophthalmology at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Funds also come from the F.M. Kirby Foundation, Research to Prevent Blindness, The Paul and Evanina Bell Mackall Foundation Trust, and the National Eye Institute, National Institutes of Health, Department of Health and Human Services, under eyeGENETM and contract Nos. HHSN260220700001C and HHSN263201200001C. The sponsor or funding organization had no role in the design or conduct of this research.
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3717. doi:
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    • Get Citation

      Allison Rhodes, Qi J Cui, Maxwell Pistilli, Ebenezer Daniel, PRITHVI SANKAR, Eydie G Miller-Ellis, Victoria Addis, Amanda Lehman, Maureen G Maguire, Joan M O'Brien; Quantifying Factors Related to Severe Vision Loss in African Americans with Primary Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3717.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Primary open-angle glaucoma (POAG) is particularly prevalent in individuals of African American descent; the phenotypic severity of POAG is greater, with the disease resulting in higher rates of blindness compared to other ethnic groups. The purpose of this study was to quantify the causes of severe vision loss (SVL) in a large African American cohort.

Methods : An electronic chart review was conducted on subjects enrolled in the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Subjects with a diagnosis of POAG and SVL (defined as VA≤20/200) in one or both eyes were included. Demographic data, ocular and medical history, and cause(s) of SVL were assessed.

Results : Eighty-nine subjects, 50 female and 39 male, were identified. Average age was 74.4±11.8yrs (mean±SD). For 52 subjects (58%) SVL was due solely to POAG, and for 37 subjects (42%) SVL in one or both eyes was due to other causes including corneal scarring/edema, retinal detachment, central and branch vein occlusion, age-related macular degeneration, cystoid macular edema, optic neuropathy, neovascular glaucoma, and trauma (all developed after POAG diagnosis) (Table 1). Eyes with SVL from POAG had thinner corneas (512.8μm vs. 539.1μm; p=0.01) and larger cup-to-disc ratios (0.92 vs. 0.75; p=0.002) compared to eyes with SVL from other causes (Table 2). Subjects with SVL from POAG underwent more glaucoma surgeries (1.1 vs. 0.3; p<0.001) and similar numbers of laser procedures (0.7 vs. 0.6; p=0.68) (Table 1). While subjects with SVL from other causes trended towards a higher prevalence of systemic illnesses such as HTN, DM, TIA and CVA, differences were not significant (p=0.07-0.63) (Table 1). In those with SVL from POAG, the group with bilateral (N=15) versus unilateral SVL (N=37) trended towards older age (76.9 vs. 73.1yrs) and male gender (53 vs. 41%), and completed fewer visits since 2012 (58.7 vs. 64.1%). However, none of these differences were statistically significant (p>0.30), which may be due to the small sample sizes, but a lack of association cannot be disproven.

Conclusions : In an African American POAG cohort with SVL in one or both eyes, approximately half of subjects experienced SVL not related to POAG, often due to conditions associated with systemic illnesses. Diagnosis and treatment of ocular and systemic disease other than POAG is important in managing POAG patients.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

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