Abstract
Purpose :
To evaluate whether Black race is associated with 1) younger age at primary open-angle glaucoma (POAG) diagnosis, and 2) more severe POAG in a national clinical registry.
Methods :
Patients with POAG and severe POAG in the IRIS® Registry (Intelligent Research in Sight) between 2015-2020 were identified based on ICD10 codes. Prevalence rates were estimated overall and by age, race, and ethnicity; associated factors were evaluated using multivariable logistic regression with odds ratios (ORs; 95% confidence intervals; CIs) determined.
Results :
Of 59,039,221 patients in the IRIS Registry between 2015-2020, 6.2% (n=3,632,085) and 1.3% (n= 769,556) were identified with POAG and severe POAG, respectively. For each race category, Blacks had the highest prevalence of POAG and severe POAG for each age group. While the highest POAG and severe POAG prevalence rates among all age-race categories were in Black patients > 60 years (18.71% POAG and 5.82% severe POAG, respectively), the second highest rates were seen in 41-60 year-old Black patients (12.00% POAG and 2.98% severe POAG). In comparison, POAG and severe POAG prevalence rates in White patients > 60 years were 8.26% and 1.67%, respectively. Race-based prevalence rate ratios (Figure 1) revealed that compared to White patients, among the other race groups, Black patients were at higher risk of having POAG and severe POAG across all age groups. This rate ratio was largest in the 21-40 year age group where Black patients were 4.3 and 6.4 times more likely to have POAG and severe POAG, respectively, compared to White patients of those ages. In a multivariable logistic regression model (Table 1), Black race was the factor with the highest odds of having POAG (OR=2.24 (95% CI: 2.24-2.25), and severe POAG (OR=3.62; 3.60-3.65).
Conclusions :
The IRIS Registry highlights a significantly greater risk of developing POAG and severe POAG, especially in the 21-40 and 41-60 age groups in Blacks compared to Whites. Analyses of genetic contributions, as well as the effects of “weathering” (health effects of stress/discrimination), may provide further insight. Glaucoma screening and education of persons of Black or African American descent should begin in early adulthood.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.