Varma R, Ying-Lai M, Francis BA, et al. 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: 6.14). 09/2004; 111(8):1439-48. DOI: 10.1016/j.ophtha.2004.01.025
Source: PubMed


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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    • "Hispanic (34%), and Asian (3.7%).17 The Los Angeles Latino Eye study reported a high incidence of open-angle glaucoma and ocular hypertension in the adult Hispanic population.18 Interestingly, when compared to the patient populations of the CMC clinic and the entire hospital, the suspect population was slightly over-represented by African Americans and under-represented by Hispanics (Figure 2). "
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    ABSTRACT: PurposeTo report demographic and ocular features of pediatric glaucoma suspects in an ethnically diverse population of North Central Texas.DesignRetrospective cross-sectional chart review.ParticipantsSubjects included 75 (136 eyes) pediatric glaucoma suspects. Patients with one or more of the following risk factors were included: cup-to disc (C/D) ratio of ≥0.6; intraocular pressure (IOP) ≥21 mmHg; family history of glaucoma; congenital glaucoma in the opposite eye; history of blunt trauma to either eye; and presence of either Sturge-Weber or Axenfeld–Rieger syndrome, or oculodermal melanocytosis.MethodsData were extracted from electronic patient medical records. Patient records with incomplete data were excluded. The main outcome measures were race, sex, age, IOP, C/D, family history of glaucoma; and glaucoma treatment.ResultsSubjects included 28 (37.3%) Hispanics, 20 (26.6%) African Americans, 20 (26.6%) Caucasians, and seven (9.3%) Asians. Forty (53.3%) of the patients were male. Suspicious optic disc was seen in 57 (76%); elevated IOP in 25 (33.3%); presence of family history in 13 (17.3%), and Sturge–Weber syndrome in nine (12%) patients. The average C/D ratio was 0.58±0.2. The C/D ratios of African American (0.65±0.2), Hispanic (0.63±0.2), and Asian (0.62±0.15) patients were significantly greater than those of Caucasians (0.43±0.18; P=0.0004, 0.0003, and 0.0139, respectively). Caucasian patients were the youngest (7.9±4.8 years). Eleven cases (14.7%) required medication.ConclusionThirty-three point seven percent of patients seen in the glaucoma clinic were glaucoma suspects. The most common risk factors for suspected glaucoma were suspicious optic discs, elevated IOP, and family history of glaucoma. Most patients required only close observation. Long-term follow-up of these patients is warranted to determine the mechanisms of conversion to glaucoma.
    Full-text · Article · Jun 2014 · Clinical ophthalmology (Auckland, N.Z.)
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    • "It affects 1 in 200 individuals up to 50 years of age, and 1 in 10 individuals over 80 years of age. This age-associated increase in glaucoma prevalence is not accompanied by a corresponding increase in intraocular pressure (IOP) [13]. A few studies have suggested that age-related changes might play a role in glaucomatous optic neuropathy such that the retina itself and/or the optic nerve has an altered susceptibility to elevated IOP or other stress injuries [14,15]. "
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    ABSTRACT: To investigate age-associated changes in retinal ganglion cell (RGC) response to elevated intraocular pressure (IOP), and to explore the mechanism underlying these changes. Specifically, the effect of aging on inhibitor of apoptosis (IAP) gene family expression was investigated in glaucomatous eyes. IOP was induced unilaterally in 82 Wistar rats using the translimbal photocoagulation laser model. IOP was measured using a TonoLab tonometer. RGC survival was evaluated in 3-, 6-, 13-, and 18-month-old animals. Changes in the RNA profiles of young (3-month-old) and old glaucomatous retinas were examined by PCR array for apoptosis; changes in selected genes were validated by real-time PCR; and changes in selected proteins were localized by immunohistochemistry. There were no significant IOP differences between the age groups. However, there was a natural significant loss of RGCs with aging and this was more prevalent in glaucomatous eyes. The number of RGCs in glaucomatous eyes decreased from 669±123 RGC/mm(2) at 3 months to 486±114 RGC/mm(2) at 6 months and 189±46.5 RGC/mm(2) at 18 months (n=4-8, p=0.048, analysis of variance). The PCR array revealed different changes in proapoptotic and prosurvival genes between young and old eyes. The two important prosurvival genes, IAP-1 and X-linked IAP (XIAP), acted in opposite directions in 3-month-old and 15-month-old rats, and were significantly decreased in aged glaucomatous retinas, while their expression increased significantly in young glaucomatous eyes. P53 levels did not vary between young glaucomatous and normal fellow eyes, but were reduced with age. B-cell leukemia/lymphoma 2 (Bcl-2) family members and tumor necrosis factor (TNF)-α expression were unaffected by age. Immunohistochemistry results suggested that the sources of changes in IAP-1 protein expression are RGCs and glial cells, and that most XIAP secretion comes from RGCs. Decreased IAP-1 and XIAP gene expression in aged eyes may predispose RGCs to increased vulnerability to glaucomatous damage. These findings suggest that aging impairs the endogenous neuroprotective mechanism of RGCs evoked by elevated IOP.
    Full-text · Article · Sep 2013 · Molecular vision
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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.
    Full-text · Article · Apr 2013 · Acta ophthalmologica
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