Association of patient race and Hispanic ethnicity with age and severity of glaucomatous vision loss at first visit

Abstract

Purpose : To investigate associations of patient race and Hispanic ethnicity with age and severity of visual field loss in glaucoma patients at first visit.

Methods : All patients from Mass. Eye and Ear glaucoma service with Humphrey visual field (VF) measurements (SITA Standard or Fast 24-2) and an electronically available, questionnaire based self-reported race as either African, Asian, or European were selected. Hispanic ethnicity was represented as a questionnaire item separate from race. Age at the time of the first visual field measurement was associated with race as well as self-reported Hispanic ethnicity. Among all reliable (false positive/negative rate ≤20%, fixation losses ≤33%) first VF measurements of each patient, analogous race and ethnicity associations with VF mean deviation (MD) as a measure of glaucoma severity were determined.

Results : Among the 17,275 selected patients (56.5% female), 2,746 identified their race as African, 1,443 as Asian, and 13,086 as European; 869 did not respond to the Hispanic ethnicity item, while 427 identified as Hispanic (70 African, 6 Asian, 351 European). There was a significant (ANOVA, p<0.001) main association between race and age at first visit (Fig. 1), with Asian being youngest patients (56.2 years), followed by Africans (57.7 years) and Europeans (62.2 years). Patients with Hispanic ethnicity were on average 6.3 years younger (54.8 years) at first visit (t-test, p<0.001). Among the 17,275 first VFs of each patient, 13,918 met the reliability criteria. There was a significant race association with MD (p<0.001; Fig. 2), with patients of African race having the most severe VF loss at first visit (-6.5 dB), followed by Asian (-4.4 dB) and European race (-3.6 dB). Hispanic patients had lower MD (-6.1 dB) than patients of non-Hispanic ethnicity (-4.0 dB) (p<0.001). While Hispanic ethnicity among patients of African race was not associated with MD, among patients of European race, Hispanics had 2.2 dB lower MD at first visit (p<0.001).

Conclusions : Patients of African and Asian race present younger at glaucoma service but still have more severe vision loss at first visit compared to European race patients. While Hispanic ethnicity among patients of African race was not associated with glaucoma severity, Hispanics or European race had significantly lower MD than patients of non-Hispanic European race.

This is a 2021 ARVO Annual Meeting abstract.

 

Fig.1 (**: p<0.01, ***: p<0.001)

 

Fig.2