Risk Factors for Four-year Incidence of Open-angle Glaucoma: The Los Angeles Latino Eye Study

Abstract

 

Purpose:

 

To investigate potential sociodemographic, lifestyle, anthropometric, clinical, and ocular risk factors for incident open-angle glaucoma (OAG) among an adult Latino population.

 

Methods:

 

The Los Angeles Latino Eye Study is a population-based, prospective cohort study of self-identified Latinos aged 40 years and older from Los Angeles, California. Data from 3,772 study participants were included for the analysis. Participants had standardized study visits at baseline and 4-year follow-up with structured interviews and a comprehensive ophthalmologic examination. Intraocular pressure (IOP) was measured by Goldmann applanation tonometry. OAG was defined as the presence of an open angle and a glaucomatous visual field abnormality and/or evidence of glaucomatous optic disc damage in at least one eye. Multivariate logistic regression with stepwise selection was performed to examine the independent association of potential risk factors with the incidence of OAG. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for each risk factor.

 

Results:

 

Over the 4-year follow-up, 87 participants newly developed OAG (2.3%). Multivariate stepwise regression revealed that the following variables at baseline were statistically significantly associated with the incidence of OAG: older age (OR per decade, 2.19; 95% CI, 1.74-2.75; P<0.001), higher IOP (OR per mmHg, 1.18; 95% CI, 1.10-1.26; P<0.001), longer axial length (OR per mm, 1.48; 95% CI, 1.22-1.80; P<0.001), lack of vision insurance (OR, 2.08; 95% CI, 1.26-3.41; P=0.004), higher waist to hip ratio (OR per 0.05 increase, 1.21; 95% CI, 1.05-1.39; P=0.007), and thinner central cornea (OR per 40 µm thinner, 1.30; 95% CI, 1.00-1.70; P=0.050). There was a significant interaction between IOP and central corneal thickness (P=0.043) with the same level of IOP having a higher impact on OAG incidence among individuals with thinner central cornea than among those with thicker central cornea.

 

Conclusions:

 

This is the first comprehensive examination of risk factors for OAG incidence among Latinos in the United States. Increased IOP remains an important risk factor for OAG. Other risk factors were also identified, indicating a multifactorial etiology of OAG development. Our study also confirmed that the effect of IOP on OAG risk was strongest among participants with thinner central cornea.

 

Keywords: clinical (human) or epidemiologic studies: risk factor assessment • intraocular pressure