Abstract
Purpose: :
To evaluate statistical differences in glaucoma parameters and treatment outcomes amongst Haitian patients in comparison with African-American patients.
Methods: :
Retrospective chart review of 200 Haitian and African American patients with Primary Open Angle Glaucoma (POAG) treated at a Boston Neighborhood Health Care Center (NHCC) within a one year time frame.
Results: :
Preliminary analysis of a subset of 38 patients demonstrates that Haitian patients on average tend to be diagnosed at a younger age than African Americans (61.6 vs. 65.4). The average presenting IOP amongst Haitians tended to be lower than that of African Americans (17.4 vs. 20.9). Pachymetry readings also tended to be lower amongst Haitian patients (515 vs. 527.5). ON cupping tended to be higher in African Americans (0.62 vs. 0.59) at the time of diagnosis. Statistical significance will be determined from analysis of all 200 patients. Progression of disease amongst both groups will be analyzed in terms of change over time in visual field parameters and optic nerve cupping.
Main Outcome Measures: :
Mean IOP, pachymetry, age at diagnosis and degree of optic nerve (ON) cupping at time of diagnosis.
Conclusions: :
POAG is the leading cause of blindness amongst African Americans. Prevalence is 3-5X higher than in Caucasians. The risk of blindness from glaucoma is 6x higher in African Americans. In Africa and the Caribbean, the risk of blindness is higher. 34% of glaucoma patients in Nigeria are bilaterally blind and 91% are monocularly blind. 4% of glaucoma patients in the US experience blindness. Such differences have been attributed to earlier diagnosis and treatment in the US. At the NHCC, glaucoma in the Haitian population tends to have poorer visual outcomes. However, very little data regarding glaucoma in the Haitian population exists in the literature. Preliminary analysis of data reveals differences among initial diagnostic glaucoma parameters between both groups. Final analysis will include 200 patients. Initial parameters will be compared with outcomes in both groups. It is hoped that such analysis will provide insight into to the roles of physiologic differences, doctors’ level of suspicion, and other cultural or socioeconomic factors in differential outcomes.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • intraocular pressure • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials