Abstract
Purpose :
Exfoliation syndrome (XFS) is a common identifiable cause of secondary open-angle glaucoma1. Estimates gathered over a decade ago on the prevalence of glaucoma in Native American populations hover around 6%; however, data is lacking regarding the burden of XFS in this population2,3. In 1971, Faulkner et al. estimated the prevalence of XFS in a sample of 50 Navajo Native Americans over the age of 60 as 38%4. Given that XFS can cause irreversible blindness secondary to glaucoma, this study aims to identify the current prevalence of XFS among Navajo Nation residents within the Four Corners region of the United States.
Methods :
A retrospective chart review was conducted from 2016-2021 for patients aged 18 and older, examined in partnership with the Utah Navajo Health System and the Moran Eye Center. All patients with XFS or XFG diagnosed by slit lamp exam were identified through chart review. Additionally, patient demographic information and ocular/systemic comorbidities were gathered.
Results :
Of the 1,152 patient charts available for review, eight patients (11 eyes) were diagnosed with XFS with three patients (4 eyes) demonstrating concomitant XFG. Of the patients with XFS, three had bilateral disease, three were right eye, and two were left eye. Within this XFS population, 50% of the patients identified as male, with a mean age of 73 years. Of patients with XFS, 38%, 50%, and 13% were seen at the Montezuma Creek, Monument Valley and Navajo Mountain sites respectively. Average presenting IOP in XFS eyes was 19.54 mmHg (n=11) and 18 mmHg (n=4) for non-XFS fellow eyes. The overall prevalence of XFS was 0.7% and the overall prevalence of XFG was found to be 0.26%. The rate of XFG among patients with XFS was 37.5%.
Conclusions :
Compared to Faulkner’s study of the Navajo Nation residents in 1971, our findings show a considerably lower prevalence of XFS at 0.7%. We present the largest population-based study to date of XFS and XFG among this population. The discrepancy of our findings compared to Faulkner’s could be due to variation in diagnostic and inclusion criteria, clinician-dependent factors, and perhaps most critically, differences in study populations. The difference could indicate unique genetic and epigenetic factors within a single ethnic group that spans a large geographic area of the American Southwest, which has not been investigated to date.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.