June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Glaucoma severity and Diabetes Control in a High-Risk Diabetic Latino Population
Author Affiliations & Notes
  • Maria Ines Vega Garces
    Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Kailyn Ramirez
    Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
  • Kimberly Cartagena
    Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Albert S. Khouri
    Ophthalmology, Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Footnotes
    Commercial Relationships   Maria Vega Garces None; Kailyn Ramirez None; Kimberly Cartagena None; Albert Khouri None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4297. doi:
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      Maria Ines Vega Garces, Kailyn Ramirez, Kimberly Cartagena, Albert S. Khouri; Glaucoma severity and Diabetes Control in a High-Risk Diabetic Latino Population. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4297.

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

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Abstract

Purpose : Glaucoma is a chronic disease that affects approximately 3 million Americans, that if left untreated can lead to permanent blindness. By 2050, CDC projects that 50% of all Glaucoma patients will be Latino. Latinos in underserved communities risk developing multiple chronic health diseases and poor self-management skills (SMS), critical in managing Glaucoma. We investigated the association between glaucoma severity and HbA1c control to further delineate the underlying effects of poor SMS in this growing population.

Methods : Demographic and clinical data was collected retrospectively from an electronic health records system at an academic medical center in Newark, NJ serving an underserved population (Median Income $20k). Patients met inclusion criteria with a confirmed clinical diagnosis of Glaucoma and Type 2 Diabetes Mellitus, on medical therapy, and having identified as Hispanic/Latino. Patients with a history of ocular laser treatment were excluded. Hemoglobin A1c values were correlated with ocular coherence tomography (OCT) Retinal Nerve Fiber Layer (RNFL) values of the superior and inferior quadrant using Pearson's linear regression. Patients were subcategorized by diabetes control using HbA1c as a proxy, determined by the American Diabetes Association criteria. Student t-tests were used to compare patient groups.

Results : 225 eyes of 131 participants were included, 71(54.9%) female, average age 62 ± 13.5 and 15(11%) had DR. For all quadrants, HbA1c predicted 1-2% of RNFL thickness in DR and non-DR groups. Mean and standard deviation of superior and inferior RNFL quadrant values respectively: controlled( N=109, 124.5 ± 81.6 ,127.44 ± 77.7 ) uncontrolled ( N=91,109.1 ± 71.4 ,± 117.6 71.3 ), DR controlled (N=15, 107.2 ± 60.5, 116.9 ± 45.2 ) , DR uncontrolled (N=9, 100.2 ± 58.1, 82.9 ± 20.1).The superior RNFL differences between controlled and uncontrolled diabetics almost reached statistical significance ( 124.5 ± 81.6 vs. 100.2 ± 58.1 p = 0.07 ). Patients in the controlled diabetes DR group had significantly greater inferior RNFL thickness than uncontrolled DR patients ( 116.9 ± 45.2 vs 82.9 ± 20.1 p < 0.05 ).

Conclusions : Patients with poor diabetic control may also have worse glaucoma severity. Larger, multi-center samples are needed to generate more generalizable results that if significant may highlight the need for SMS program referral in Latino glaucoma patients with multiple comorbidities.

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

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