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Amirmohsen Arbabi, Wesam Shamseldin Shalaby, Jonathan S. Myers, Marlene R. Moster, Reza Razeghinejad, L. Jay katz, Aakriti Garg Shukla; Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3416.
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To determine the potential impact of sociodemographic and economic factors on the neovascular glaucoma (NVG) tube shunt surgery outcomes
This retrospective, single center, comparative case series included consecutive patients who underwent tube shunt surgery for NVG and had ≥ 6 months of follow-up. Regional average adjusted gross income (AGI) was determined by cross-referencing self-reported residential zip codes with average AGI per zip code supplied by the Internal Revenue Service. Two groups were created: 1) lower income - individuals from neighborhoods with the lowest 10% of AGI (near the United States poverty line), 2) higher income – the remaining 90% of individuals. Main outcome measures were visual acuity (VA), intraocular pressure (IOP), and glaucoma medication number at 6 months and the most recent visit.
Mean annual AGI in the higher income group (130 patients) was $69,596 ±39,700 and the lower income group (16 patients) was $27,487 ±1,600 (P < 0.001). Age, sex, distance to the clinic, language, and all baseline clinical variables (including VA and IOP) were comparable between groups. Lower income was associated with non-white race (81.3% vs. 52.3%; P = 0.024). At month 6, VA in the lower income group (median: HM, range: 20/70 – NLP) was worse than the higher income group (median: CF, range: 20/25 – NLP) (logMAR VA : 2.32 ± 0.8 vs. 1.77 ± 1.1; P = 0.02); these trends persisted through the most recent visit (P = 0.043) (Figure 1). Follow-up IOP and medications were similar between groups.
Our study analyzed a possible relationship between income and outcomes after surgery for NVG and found that despite similar preoperative characteristics in the two groups, those with lower income had significantly worse VA at postoperative month 6 and at their most recent visit. Furthermore, the lower income group had a higher proportion of non-white race, which may have affected surgical outcomes. Additional study on this potential association is warranted and may help guide clinicians in counseling patients and provide further insight regarding reasons for worse visual outcomes in the most vulnerable populations.
This is a 2021 ARVO Annual Meeting abstract.
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