Prevalence of open-angle glaucoma and ocular hypertension in Latinos - The Los Angeles Latino Eye Study

Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, 90033, USA.
Ophthalmology (Impact Factor: 6.17). 09/2004; 111(8):1439-48. DOI: 10.1016/j.ophtha.2004.01.025
Source: PubMed

ABSTRACT To estimate age- and gender-specific prevalences of ocular hypertension and open-angle glaucoma (OAG) in adult Latinos.
Population-based, cross-sectional study.
Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California.
The study cohort consisted of all self-identified Latinos of primarily Mexican ancestry 40 years and older residing in 6 census tracts in La Puente, California. All participants underwent a complete ophthalmologic examination, including measurement of intraocular pressure (IOP), visual field (VF) testing using an automated field analyzer, and simultaneous stereoscopic fundus photography of the optic disc. Ocular hypertension was defined as IOP of >21 mmHg and the absence of optic disc damage or abnormal VF test results. Open-angle glaucoma was defined as the presence of an open angle and various criteria that included a glaucomatous VF abnormality and/or evidence of glaucomatous optic disc damage in at least one eye.
Prevalence of open-angle glaucoma and ocular hypertension.
For the 6142 participants who underwent a complete ophthalmologic examination at the clinical center, the prevalence of OAG was 4.74% (95% confidence interval [CI], 4.22%-5.30%). The prevalence of ocular hypertension was 3.56% (95% CI, 3.12%-4.06%). The prevalences of OAG and ocular hypertension were higher in older Latinos than in younger Latinos (P<0.0001). No gender-related differences in prevalences of OAG and ocular hypertension were present. The mean IOP, mean deviation, and mean vertical cup-disc ratio in persons with OAG were 17 mmHg, -9.6 decibels, and 0.6, respectively. Seventy-five percent of Latinos with OAG and 75% of Latinos with ocular hypertension were previously undiagnosed. Further, 17% of Latinos with OAG and 23% of Latinos with ocular hypertension had received treatment for "glaucoma."
Our data suggest that the prevalence of OAG is high among Latinos of Mexican ancestry. The higher prevalence of OAG in older Latinos emphasizes the public health importance of providing eye care services for the early diagnosis and management of this condition in Latinos.

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    • "Also, in the same study, mean (SD) IOP was 18.7 (5.2), 18.2 (3.8) and 16.5 (3.0) mmHg in black, mixed race and white participants, respectively (Leske et al. 1997). A higher prevalence of OAG in Hispanic than in white populations has also been reported, but this seems to be related to other factors than elevated IOP, as there is no clear evidence for higher IOP in Hispanics (Quigley et al. 2001; Varma et al. 2004). Vitamin D has attained much focus over the last couple of decades as a possible multifunctional and important contributor to health, and especially in the context of chronic lifestylerelated diseases. "
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    ABSTRACT: Purpose: To study the associations between serum 25-hydroxy-vitamin D (25(OH)D) levels, vitamin D administration and intraocular pressure (IOP). Methods: The design of the study included a nested case-control study and a randomized controlled intervention trial. In the first part, healthy Caucasians with high or low serum 25(OH)D levels were recruited from a population-based study. IOP of the right eye was measured by the use of a rebound tonometer. In the second part, those with low serum 25(OH)D levels were randomized to receive either capsules of vitamin D3 20 000 IU twice per week or placebo for 6 months before IOP was measured again. Results: Intraocular pressure in the 87 participants with low serum 25(OH)D levels (mean 40.1 ± 12.9 nm) did not differ from IOP in the 42 participants with high serum 25(OH)D levels (mean 85.1 ± 14.0 nm) (15.9 ± 3.3 mmHg versus 15.6 ± 3.1 mmHg, p = 0.56, independent t-test). After intervention, IOP decreased by -0.8 ± 2.1 mmHg (p = 0.017, paired t-test) in the vitamin D group (n = 39) and -0.8 ± 2.5 mmHg (p = 0.059) in the placebo group (n = 39), but the change was not significantly different between the groups (p = 0.92, independent t-test). Conclusion: This study in healthy participants revealed no associations between serum 25(OH)D levels and IOP, and administration of vitamin D3 to participants with low levels of 25(OH)D did not affect IOP. These results do not support a role of vitamin D in the regulation of IOP.
    Acta ophthalmologica 04/2013; 92(4). DOI:10.1111/aos.12125 · 2.51 Impact Factor
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    • "et al. 2004; Stein et al. 2011). Population-based studies have reported a higher age-adjusted prevalence of OAG among African Americans, Asian Americans and Latinos compared with whites (Tielsch et al. 1991; Friedman et al. 2004, 2006; Stein et al. 2011), and Latinos of Mexican ancestry have been shown to have a higher incidence of OAG than Caucasians (Varma et al. 2004). Although it is important to describe these epidemiologic trends, it is essential to determine their origin and whether specific known glaucoma risk factors vary systematically by race ⁄ ethnicity. "
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    ABSTRACT: Purpose:  To determine whether differences in corneal hysteresis (CH) and central corneal thickness (CCT) between black, Hispanic and white subjects exist independently of one another. Methods:  Retrospective, cross-sectional data were reviewed for 807 eyes of 410 patients consecutively evaluated for glaucoma. Included patients had open angles, at least one reliable 24-2 perimetric examination and no evidence of nonglaucomatous vision loss. Patients underwent CH measurement with the ocular response analyzer followed by CCT measurement and full ocular examination. Patients were asked to self-classify their race or ethnicity. Statistical analyses were performed to identify characteristics that varied between black, Hispanic and white subjects and to explain this variation. Results:  Of the 270 patients (511 eyes) included, 84 were black, 96 Hispanic and 90 white. There were no significant differences in diagnosis, sex, age, intraocular pressure or glaucoma severity between races/ethnicities (p ≥ 0.16). Blacks were found to have lower CCT (529.3 μm) and CH (8.7 mmHg) compared to Hispanics (544.7 μm, p = 0.008; 9.4 mmHg, p = 0.007) and whites (549.9 μm, p < 0.001; 9.8 mmHg, p < 0.001). On multivariable analysis, inter-racial/ethnic differences in CCT were not found to exist independent of CH (p ≥ 0.10), whereas the significant intergroup variation in CH remained after adjustment for CCT and other covariates (p ≤ 0.005). Conclusions:  Variation in CCT between races/ethnicities does not exist independent of CH. However, significant intergroup variation in CH is present independent of CCT. This finding suggests that CH may be a preferable measurement to evaluate intergroup differences in corneal properties and their relationship to open-angle glaucoma.
    Acta ophthalmologica 08/2012; 90(8). DOI:10.1111/j.1755-3768.2012.02509.x · 2.51 Impact Factor
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    • "Prevalence estimates for open-angle glaucoma by age groups. Mitchel P et al 1999 Pogdor MJ et al 1983 National Eye Inst, USA 2004 Varma R et al 2004 Leske MC et al 2001 Buhrmann et al 2000 Quigley H et al 2001 Jonasson F et al 2003 0 5 10 15 20 25 30 35 40 45 40 -49 50 -59 60 -69 70 -79 80 + "
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    ABSTRACT: Refractive errors and primary open-angle glaucoma are common eye conditions in the United States. The identification and quantification of risk factors for primary open-angle glaucoma is critical to understanding and managing the disease process from both individual and public health perspectives. This narrative review was conducted to present the epidemiology of primary open-angle glaucoma and to summarize epidemiologic findings on myopia as a risk factor. Epidemiologic evidence suggests an increasing prevalence of primary open-angle glaucoma over the last decade in the United States. It has been documented that primary open-angle glaucoma prevalence increases with age, and that African Americans tend to have the highest estimates. Epidemiologic data, however, are not as clear with respect to gender differences. Other factors that have been identified are increased intraocular pressure and the use of steroids. The evidence for increased risk of primary open-angle glaucoma among myopies is stronger for moderate and severe myopia and not as clear for mild myopia. The association between primary open-angle glaucoma and its multiple risk factors is complex.
    WMJ: official publication of the State Medical Society of Wisconsin 05/2007; 106(2):85-9, 95.
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