Abstract
Purpose :
To examine the prevalence of glaucoma by race/ethnicity in the 2019 California (CA) Medicare population.
Methods :
The study population included all 2019 CA Medicare beneficiaries ≥65 years old who had both Part A and Part B coverage. Race/ethnicity was obtained from the Medicare enhanced race/ethnicity code and was categorized into White, Black, Asian, Hispanic, and Other/Unknown. Glaucoma was defined by diagnosis codes and included any glaucoma, primary open angle glaucoma (POAG), secondary open angle glaucoma (SOAG), and angle closure glaucoma (ACG). Covariates included age, sex, Charlson Comorbidity Index, pseudophakia, and macular degeneration. Univariable comparisons of glaucoma prevalence by race/ethnicity was performed using chi-squared tests. Multivariable analyses were performed using logistic regression, while adjusting for all covariates.
Results :
The study population included 5,856,492 CA Medicare beneficiaries, of whom 3,340,658 (57.0%) were White, 317,631 (5.4%) were Black, 760,673 (13.0%) were Asian, 1,203,503 (20.6%) were Hispanic, and 234,027 (4.0%) were Other/Unknown. There were 220,662 (3.8%) beneficiaries with any glaucoma, 171,988 (2.9%) with POAG, 8,827 (0.2%) with SOAG, and 12,978 (0.2%) with ACG. Compared to White beneficiaries, Black, Asian, Hispanic, and Other/Unknown beneficiaries had increased adjusted odds of any glaucoma (Black odds ratio [OR]=1.70, 95% confidence interval [CI]=1.67, 1.73; Asian OR=1.60, 95% CI=1.58, 1.62; Hispanic OR=1.05, 95% CI=1.04, 1.07; Other/Unknown OR=1.30, 95% CI=1.27, 1.33), POAG (Black OR=1.79, 95% CI=1.75, 1.83; Asian OR=1.40, 95% CI=1.38, 1.42; Hispanic OR=1.07, 95% CI=1.06, 1.09; Other/Unknown OR=1.26, 95% CI=1.23, 1.30), and ACG (Black OR=2.18, 95% CI=2.02, 2.37; Asian OR=5.09, 95% CI=4.89, 5.30; Hispanic OR=1.69, 95% CI=1.60, 1.78; Other/Unknown OR=2.05, 95% CI=1.88, 2.24) but lower adjusted odds of SOAG for most race/ethnicities (Black OR=0.30, 95% CI=0.25, 0.35; Asian OR=0.47, 95% CI=0.44, 0.51; Hispanic OR=0.47, 95% CI=0.44, 0.51; Other/Unknown OR=1.17, 95% CI=1.06, 1.29).
Conclusions :
In the 2019 CA Medicare population, there were racial/ethnic differences in the prevalence of glaucoma with higher odds in Black and Asian relative to Hispanic and White populations, which is different from prior population-based studies. Further investigation is required to determine the etiology of these differences.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.