Social factors associated with the risk of converting to definite glaucoma among glaucoma suspect patients: an All of Us study

Abstract

Purpose : To investigate social factors associated with the risk of diagnosis status conversion from glaucoma suspect (GS) to open-angle glaucoma (OAG).

Methods : We included participants in the nationwide All of Us dataset diagnosed with GS and collected information on potentially relevant social, demographic, and clinical factors. We then performed a retrospective follow-up and identified those who converted to a diagnosis of OAG within 5 years (the “conversion” group). The characteristics of the conversion group were then compared with those who did not convert. Multivariable Cox regression analysis was used to estimate the hazard ratios (HRs) of factors associated with the risk of conversion.

Results : We identified 5208 GS patients, 725 (14%) of whom converted to OAG within 5 years. In the multivariable Cox regression model, Black/African American race was the factor most associated with an increased risk of conversion to glaucoma (HR 1.66 [95% CI 1.40 - 1.97]). Other factors showing statistically significant association were age at diagnosis (HR 1.18 [95% CI 1.11 - 1.27] per 10 years), being employed at time of GS diagnosis (HR 0.72 [95% CI 0.60-0.87]), male gender (HR 1.27 [95% CI 1.10-1.47]), reported inability to afford care (HR 2.22 [95% CI 1.15-4.30]), and ability to see health care providers of similar race/religion (HR 0.88 [95% CI 0.79 -0.98]) (Fig. 1).

Conclusions : Several social factors were significantly associated with diagnosis status conversion from GS to OAG, which may help to identify patients at higher risk of disease progression. Future studies are needed to examine the mechanisms behind these findings and the potential interventions that could address them.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Hazard ratios of predictors of conversion to glaucoma in Cox proportional hazards model.