New research examines disparities in vision loss in glaucoma cases.
Black patients have a significantly higher risk of advanced vision loss after a new diagnosis of primary open-angle glaucoma (POAG) compared to white patients, according to a recent study.
Published in Translational Vision Science and Technology,1 Researchers from the New York Eye and Ear Infirmary of Mount Sinai (NYEE) have found that being of African descent is an independent risk factor for drastically reduced vision after diagnosis.
The findings should spur more eye screening in the black population for early detection of glaucoma, Mount Sinai Hospital/Mount Sinai School of Medicine said in a news release.2
“This study has huge implications for screening for glaucoma in black patients, who we already knew were a population at increased risk for glaucoma,” says lead author Louis R. Pasquale, MD, vice president. of ophthalmology research at the Icahn School of Medicine at Mount Sinai and director of the NYEE Eye and Vision Research Institute. “Screening earlier in life could significantly increase the chances of detecting glaucoma and slowing its progression before it reaches one of the advanced patterns shown in our research.”
POAG is the leading cause of optic nerve degeneration related to the level of pressure inside the eye, but other factors also contribute to this condition, Mount Sinai said. “Patients typically show few or no symptoms until the disease progresses and they experience irreversible vision loss, underscoring the need for early screening and detection of glaucoma in age groups. high-risk patients.”
This is the first study to use an artificial intelligence algorithm to break down visual field loss in incident glaucoma cases among US-based population groups, according to Mount Sinai.
A team of researchers analyzed nearly 210,000 participants from 3 population databases of nurses and healthcare professionals from the Nurses’ Health Study (enrolled between 1980 and 2018, and 1989-2019) and the Health Professionals Follow-up Study (enrolled between 1986 and 2018). Data from participants was collected during comprehensive eye exams – none had glaucoma at baseline. They were followed every two years and provided updated information on their lifestyle, diet and health status, including the diagnosis of glaucoma.
In the study group, 1946 patients developed glaucoma. The researchers analyzed their first visual field loss recording using archetype analysis, a form of artificial intelligence. The algorithm identified 14 archetypes: 4 representing advanced loss patterns, 9 early loss and 1 no visual field loss.
Although black patients made up 1.3% of the study, they were at nearly twice the risk of early visual field loss archetypes and six times the risk of advanced field loss archetypes, compared to compared to white patients.
“African ancestry is a risk factor for glaucoma-related blindness, and this work provides insight into why this might be the case. We suspect that why black people exhibited more advanced loss patterns than whites is that the disease begins 1 to 2 decades earlier in the former group compared to the latter group,” Pasquale said. “This underscores the importance of early screening strategies in black patients to identify early glaucoma in order to to avoid visual impairment in this population.”
Asian participants, who made up 1.2% of the group, had nearly twice the risk of early visual field loss compared to white patients, but did not have a significantly higher rate of advanced patterns of field loss. visual.
Hispanic patients represented 1.1% of the study population and had no increased risk of archetypes compared to white patients. However, the study showed that they were at risk of having an archetype showing initial loss near the center of their visual field.
The next step in this research is to determine the specific risk factors for the different patterns of vision loss seen in patients with glaucoma, including genetic and environmental factors, according to Pasquale.
1. Kang J, Wang M, Frueh L, et al. Cohort study of race/ethnicity and incident primary open-angle glaucoma characterized by self-determined patterns of visual field loss. Transl Vis Sci Technol. 2022 Jul 8;11(7):21. doi: 10.1167/tvst.11.7.21.
2. Black patients are six times more likely to have advanced vision loss after a diagnosis of glaucoma than white patients. Press release. Mount Sinai Hospital / Mount Sinai Medical Schools. July 25, 2022. Accessed August 7, 2022. https://www.eurekalert.org/news-releases/959248