Prevalence and Risk Factors of Open-Angle Glaucoma in an Adult Chinese American Population: The Chinese American Eye Study.

Purpose

To estimate the prevalence of and identify risk factors associated with open-angle glaucoma (OAG) among adult Chinese Americans.

Design

Population-based, cross-sectional study.

Participants

A total of 4582 Chinese Americans aged 50 years and older residing in Monterey Park, California.

Methods

Participants from the Chinese American Eye Study underwent a comprehensive interview, eye examination, and ophthalmic testing. OAG was defined by characteristic optic nerve head changes with or without corresponding visual field loss, as determined by a panel of glaucoma specialists, and required at gonioscopic confirmation of least 2 quadrants of visible pigmented trabecular meshwork. Candidate risk factors comprised demographic, clinical, and ocular characteristics. Multivariable logistic regression analysis was used to identify independent risk factors associated with OAG.

Main outcome measures

Prevalence of and independent risk factors associated with OAG.

Results

Of the 4310 participants with complete data, the prevalence of OAG was 4.8% (207/4310), ranging from 2.8% among those aged 50 to 59 years to 14.8% among those 80 years and older. Of those with OAG, 68.5% were previously undiagnosed or untreated, and 88.5% had intraocular pressure (IOP) ≤21 mm Hg. Independent risk factors for OAG, adjusting for sex, were older age (odds ratio [confidence interval] = 1.06 [1.05-1.08], per year); higher IOP (1.12 [1.08-1.17], per mm Hg); longer axial length (1.36 [1.25-1.47], per mm); family history of glaucoma (1.88 [1.19-2.97]); and diabetes mellitus (1.49 [1.05-2.11]).

Conclusions

The prevalence of OAG among Chinese Americans may be higher than that reported in US populations of European descent and in Asia-based Chinese populations, but lower than that observed in Latinos in Los Angeles and individuals of African Caribbean descent. More than two-thirds of OAG cases in our study were previously undiagnosed or untreated, with a majority presenting with IOP ≤21 mm Hg. These findings highlight the importance of identifying high-risk individuals based on age, IOP, axial length, family history, and diabetes mellitus. Given the high prevalence of myopia, future research should evaluate whether interventions to prevent myopia could help reduce the risk for developing OAG.