In American journal of ophthalmology ; h5-index 67.0
PURPOSE : Glaucoma is the leading cause of irreversible blindness, a crippling disability resulting in higher risks of chronic health conditions. To better understand disparities in blindness risk, we identified risk factors of blindness upon first presentation to a glaucoma clinic using a large clinical database.
DESIGN : Retrospective cross-sectional study.
METHODS : We used electronic health records of glaucoma patients from the Duke Ophthalmic Registry. International Classification of Diseases codes were used to identify glaucoma and exclude concurrent diseases. Blindness classification was based on the definition of legal blindness. Risk factors included gender, race, marital status, age, intraocular pressure, diabetes history, income level, and education. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for risk factors using univariable and multivariable logistic regression.
RESULTS : Our cohort consisted of 3,753 patients, with 192 (5%) blind upon first presentation. In univariable models, African American/black race (OR: 2.48; 95% CI: 1.83, 3.36), single marital status (1.74; 95% CI: 1.25, 2.44), prior diabetes diagnosis (2.23; 95% CI: 1.52, 3.27), and higher IOP (1.29 per 1 standard deviation higher; 95% CI: 1.13, 1.46) were associated with increased risk of presenting blind while higher annual income (0.75; 95% CI: 95% 0.65, 0.86) and education (0.77; 95% CI: 0.69, 0.85) were associated with lower risk. These associations remained significant and in the same direction in a multivariable model apart for income, which became insignificant.
CONCLUSIONS : Using a large real-world clinical database, we identified risk factors associated with presentation with blindness among glaucoma patients. Our results highlight disparities in healthcare outcomes and indicate the importance of targeted education to reduce disparities in blindness.
Shi Alyssa, Berchuck Samuel I, Jammal Alessandro A, Singh Geetika, Hunt Sydney, Roche Kimberly, Mukherjee Sayan, Medeiros Felipe A
2023-Feb-08
