Abstract
Purpose :
Determine the efficacy of selective laser trabeculoplasty (SLT) monotherapy among individuals of Hispanic descent with mild-moderate primary open-angle glaucoma (POAG).
Methods :
Adults with mild-moderate POAG (MD ≥-12db) had baseline intraocular pressure (IOP) assessed after a 30-day medication washout. IOP assessments were the median of 3 masked Goldmann applanation tonometry readings performed serially by 3 examiners. All eyes underwent 360° SLT performed by a single surgeon (WES). IOP was assessed 1, 4, and 12 wks post-operatively.
Results :
31 eyes (15 R, 16 L) of 19 patients (10M, 9F, mean age: 63y) were enrolled. Self-reported race: 12 Hispanic, 4 white and 3 black. Of these, one non-responder was placed on topical medication and withdrawn from the study. Of remaining subjects, mean IOP for the cohort decreased significantly from baseline at each time point (R/L 1wk: -6.3±1.4/-5.1±1.6; 4wk: -6.4±2.0/-5.8±1.2; 12wk: -5.1±1.3/-5.1±1.6; mean±sem mmHg, p<.05 for each, 2-tail t-test). There was no significant difference between R and L eyes nor among the 3 post-operative time points. IOP reduction at 12 wk was 24% Hispanics, 18% non-Hispanics (racial difference p=.62). Success rates at 12 wk (success: ≥20% reduction in IOP from baseline) were Hispanics: 73%, non-Hispanics: 66% (racial difference p=.67, chi-square). There were no serious complications, but 2 patients (1 Hispanic and 1 non-Hispanic) experienced post-operative IOP spikes that required intervention.
Conclusions :
SLT monotherapy is effective in lowering the IOP of Hispanic patients with POAG in South Texas. Our observed mean 24% IOP reduction among Hispanics is less than that reported in Afro-Caribbeans (38% at 12 wks; Realini, Am J Ophthalmol. 2017), Chinese (31% at 12 wks; Lai, Clin Exp Ophthalmol 2004) and Indians (28% at 12 mos; Goosen, J Curr Glaucoma Pract 2017); but greater than that reported from Korea (15% at 12 wks; Kim, Ophthal Surg Lasers. 2000), Slovenia (16% at 12 wks; Cvenkel, Ophthalmologica 2004) and Canada (21% at 12 wks; Damji, Br J Ophthalmol. 2006). To our knowledge this is the first report of SLT effectiveness among Hispanics.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.