Visual Field Variability Leads to Delayed Glaucoma Detection in Black Patients

Friday, May 21, 2021

Primary open-angle glaucoma is known to cause more functional impairment in Black individuals compared with whites. Though the cause of this disparity is not clear, there are a number of proposed explanations. Black individuals may develop glaucoma at an earlier age, present with more extensive damage, experience faster progression, be less adherent to treatment and have less access to healthcare.

Duke researchers and colleagues gleaned additional insight following a recent study published in the British Journal of Ophthalmology.  The results suggest that Black patients had larger visual field variability compared with white patients. This relationship was strongly influenced by socioeconomic status and may partially explain racial disparities in glaucoma outcomes.

In the study, “Longitudinal visual field variability and the ability to detect glaucoma progression in Black and white individuals,” a retrospective observational cohort study used data from 1103 eyes from 751 white individuals and 428 eyes from 317 Black individuals.  The difference in visual field variability between Black and white patients was greater at lower levels of income and led to a delay in detection of glaucoma progression.

The authors include Duke Faculty, former Duke glaucoma fellows, current trainees and colleagues from peer institutions.

The association of race with visual field variability was influenced by socioeconomic status, with a greater difference in visual field variability between black and white individuals at lower incomes. In simulation modelling of eye trajectories, we identified a delay in identification of progression in blacks caused by the larger values of visual field variability. These findings may contribute to worse clinical outcomes that are often seen in black patients.

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