Glaucoma Treatment Outcomes in Open Angle Glaucoma Patients of African Descent.
Siesky Brent, Harris Alon, Belamkar Aditya, Zukerman Ryan, Horn Avery, Verticchio Vercellin Alice, Mendoza Kristen A, Sidoti Paul A, Oddone Francesco
AI Summary
This review highlights that glaucoma treatments like prostaglandin analogues and laser trabeculoplasty may be more effective in African-descent patients, while trabeculectomy may fail more often, emphasizing the need for tailored, prospective research.
Abstract
Open angle glaucoma (OAG), characterized by structural changes to the optic nerve head and retinal nerve fiber layer, is a progressive multifactorial optic neuropathy and a leading cause of irreversible blindness globally. Currently, intraocular pressure is the only modifiable risk factor; however, others have been identified, including genetics and race. Importantly, OAG is much more prevalent in persons of African descent (AD) compared with those of European descent (ED). OAG patients of AD are also known to have a more severe course of the disease, a finding potentially explained by structural and/or vascular differences within eye tissues. In addition, disparities in treatment outcomes have been identified in OAG patients of AD. Specifically, prostaglandin analogues have been suggested to be more effective in patients of AD than in those ED, while beta-adrenergic receptors have been suggested to be less effective, although the evidence is inconsistent. AD has also been identified as a risk factor for trabeculectomy failure while laser trabeculoplasty has been conversely found to be very effective in lowering intraocular pressure in patients of AD. Alternative surgical options, including Ex-Press shunt implantation, viscocanalostomy, and canaloplasty are promising in equivalence but require further research to evaluate disparity in outcome properly. In addition to treatment outcomes, social disparities affecting clinical care also exist for AD persons in the form of reduced adherence, access, and choice. Overall, data suggest the need for properly designed prospective trials with AD populations as a primary focus to identify the potential mechanisms driving disparities in treatment and address overall potential bias in glaucoma management.
MeSH Terms
Shields Classification
Key Concepts6
Prostaglandin analogues have been suggested to be more effective in open angle glaucoma (OAG) patients of African descent than in those of European descent.
Beta-adrenergic receptors have been suggested to be less effective in open angle glaucoma (OAG) patients of African descent, although the evidence is inconsistent.
African descent has been identified as a risk factor for trabeculectomy failure.
Laser trabeculoplasty has been found to be very effective in lowering intraocular pressure in open angle glaucoma (OAG) patients of African descent.
Open angle glaucoma (OAG) is much more prevalent in persons of African descent (AD) compared with those of European descent (ED).
Open angle glaucoma (OAG) patients of African descent (AD) are known to have a more severe course of the disease.
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