Purpose:
To investigate the relationship between socioeconomic status and the extent of visual field loss in glaucoma patients at their first presentation to Manchester Royal Eye Hospital, (MREH).
Methods:
Ninety patients attending MREH between the years 1995 and 2005 were selected from a visual field database of patients with primary open angle glaucoma. Using the first visual field record of the worse eye, selection assured that ~30 patients fell into each of 3 Mean Deviation bands (>-5dB, -5 to >-15, <-15dB). A guide as to the socioeconomic status of each patient was obtained from the ACORN registry using the patient’s postcode address. Postcode addresses in the UK geographically locate regions of approx. 15 households and the ACORN registry uses a variety of databases to classify those living within each postcode area into one of 5 socioeconomic bands (Wealthy achievers, Urban prosperity, Comfortably off, Moderate means and Hard pressed). For the purposes of our analysis we placed the first 3 bands in to Group 1 and the last 2 in to Group 2. Data on IOP, vertical CD ratio and family history of glaucoma were extracted from the patient’s notes.
Results:
41 patients were classified into Group 1 (Mean age 69.05years, Male 42%)and 49 patients into Group 2 (mean age 68.97 years, Male 48%). There was no significant difference in IOP (p=0.089) or vertical CD ratio (p=0.776) between the two groups although more people in Group 1 had a family history of Glaucoma (27% vs 14%). The distribution of visual field loss by Group is given in Figure 1.Figure 1.Ordinal logistic regression of this data showed that patients with severe visual field loss are more likely to be in Group 2 than in Group 1 (OR 3.6, 95% C.I. 1.14 -11.1).
Conclusions:
The extent of visual field loss in glaucoma patients at first presentation to MREH is related to the socioeconomic status. Patients from poorer socioeconomic groupings are more likely to present with advanced visual field loss.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • perimetry • visual fields