June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Risk Factors for Short Term Diagnostic Change from Glaucoma Suspect (GS) to Primary Open Angle Glaucoma (POAG) and POAG to GS
Author Affiliations & Notes
  • Chaitanya G Kalathuru
    Ruiz department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
  • Nicole V Carrabba
    Ruiz department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
  • Lillian K To
    Ruiz department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
  • Alice Z Chuang
    Ruiz department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
  • Logan M Smith
    Ruiz department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
  • Robert M Feldman
    Ruiz department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
  • Footnotes
    Commercial Relationships   Chaitanya Kalathuru None; Nicole Carrabba None; Lillian To None; Alice Chuang None; Logan Smith None; Robert Feldman None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4316. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Chaitanya G Kalathuru, Nicole V Carrabba, Lillian K To, Alice Z Chuang, Logan M Smith, Robert M Feldman; Risk Factors for Short Term Diagnostic Change from Glaucoma Suspect (GS) to Primary Open Angle Glaucoma (POAG) and POAG to GS. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4316.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : The incidences and baseline risk factors for short-term diagnostic changes between primary open-angle glaucoma (POAG) and glaucoma suspect (GS) status are unknown. This study was performed to determine potential causes of this variability.

Methods : Charts of patients diagnosed as POAG or GS between 1/1/2013 and 12/1/2020 with a diagnosis reversal within 24 months were reviewed. Exclusion criteria were age < 40 years, secondary glaucoma, anatomically narrow-angle, previous intraocular surgery except for refractive surgery and uncomplicated phacoemulsification, and moderate or worse non-proliferative diabetic retinopathy. Eligible patients were assigned to the Case group. Each case was matched to a control ±10 years of age with the same initial diagnosis that was unchanged, diabetes status, refractive error, and lens status. Demographics, baseline characteristics, and whether diagnostic exams/tests were performed, including pachymetry, visual field (VF), optical coherence tomography (OCT) tests, and disc and gonioscopic exams at the initial diagnosis visit were recorded.

Results : There were 89 patients whose diagnosis changed among 2,377 patients with that diagnosis. Each case was control matched. 72 (81%) changed from GS to POAG while 17 (19%) changed from POAG to GS. The cases had significantly fewer patients with a family history of glaucoma [25 (28%) for Cases vs 40 (45%) for Controls, P=0.027] and more pre-existing unrelated VF defects [18 (20%) for Cases vs 4 (4%) for Controls, P=0.002]. At the initial diagnosis, the cases were less likely to be diagnosed by the glaucoma specialist [36 (40%) for Cases vs 51 (57%) for Controls, P=0.036] and less likely to have a visual field test [28 (31%) for Cases vs 45 (51%) for Controls, P=0.015] or gonioscopic exam [30 (34%) for Cases vs 49 (55%) for Controls, P=0.002]. There were no differences (P>0.05) in sex, race, hypertension, autoimmune diseases, pachymetry, OCT test, and disc examination between the two groups.

Conclusions : The frequency of diagnostic change on reevaluation during the first two years is low. Among factors not matched, not seeing a glaucoma specialist, not performing all of the American Academy of Ophthalmology(AAO) recommended examinations, and the presence of an unrelated VF defect were the largest risk factors for initial misclassification of patients.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×