Abstract
Purpose :
Glaucoma disproportionately affects people of African descent. The population of Jamaica, the largest English-speaking Caribbean country, is approximately 90%. A prior national health survey indicated a prevalence of known glaucoma in excess of 12% in older individuals. True prevalence is likely much higher given the structure of vision health care. We sought to establish the foundation for a robust clinical profile of glaucoma in Jamaica.
Methods :
At Kingston Public Hospital (KPH), which serves the majority (67%) of the Jamaican health care population, we reviewed over 1,000 Optical Coherence Tomography (OCT) scans from glaucoma patients. OCT scans with appropriate signal strength were cross-matched to a paper patient docket to confirm 2 comprehensive ophthalmologic encounters and glaucoma diagnosis. Dockets with documentation of at least one visual field (VF) test were evaluated as a robust clinical subset. Outcomes measures included OCT parameters (assessment of vertical cup-to-disc ratio [VCDR], retinal nerve fiber layer [RNFL], rim and disc area [RA, DA], and cup volume [CV]) and, in the subset, perimetry results included Visual Field Index (VFI), Mean Deviation (MD), and Pattern Standard Deviation (PSD).
Results :
In 257 KPH patients, mean age was 57.99±12.41 years; 69.3% were female; 100% self-reported African descent. Ocular parameter averages included: RNFL symmetry: 60.44 ± 35.15%; RNFL thickness: 81.46±18.23 μm; RA: 1.03 ± 0.35 mm2; DA: 2.24 ± 0.44 mm2; CDR: 0.71 ± 0.20; VCDR: 0.69 ± 0.14; and CV: 0.61 ± 0.35. In 186 patients with VF: mean age was 56.88 ± 12.18 years; 75.3% were female; VFI: 72.15 ± 33.14%; MD: -11.34 ± 9.34 dB; PSD: 4.66 ± 3.11 dB. Expanding to include 50 private clinical patients did not meaningfully impact average ocular parameters.
Conclusions :
In this preliminary retrospective, observational hospital-based study, we summarized glaucoma-relevant clinical data from ophthalmology clinic patients in Kingston, Jamaica. These foundational data provide a wealth of valuable information on an unstudied, high-risk population, including establishing feasibility of collecting descriptive ocular data to characterize the clinical profile of glaucoma. We are in the process of expanding this study design to additional public and private hospitals throughout Jamaica, with the intent of creating an island-wide clinical profile of glaucoma.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.