Projected Clinical Outcomes of Glaucoma Screening in African American Individuals

Ladapo, Joseph A.; Kymes, Steven M.; Ladapo, Jonathan; Nwosu, Veronica C.; Pasquale, Louis R.

doi:10.1001/archopthalmol.2011.1224

Cited by 21 publications

(25 citation statements)

References 42 publications

(49 reference statements)

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“…For example, Ladapo and colleagues estimated that implementation of a national glaucoma screening program for African Americans aged 50 to 59 years with unrecognized glaucoma would reduce the lifetime prevalence of undiagnosed glaucoma from 50% to 27%. 30 …”

Section: Discussionmentioning

confidence: 99%

The Philadelphia Glaucoma Detection and Treatment Project

et al. 2016

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Purpose To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma. Design Retrospective analysis. Participants A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia. Methods Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario. Main Outcome Measures Detection rates of glaucoma-related diagnoses and types of treatments administered. Results Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT, and 103 (6.2%) who were prescribed IOP-lowering medication. Conclusions Targeting individuals at risk for glaucoma in underserved communities in Philadelphia yielded a high detection rate (39.1%) of glaucoma-related diagnoses. Providing examinations and offering treatment, including first-line laser procedures, at community-based sites providing services to older adults are effective to improve access to eye care by underserved populations.

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Section: Discussionmentioning

confidence: 99%

The Philadelphia Glaucoma Detection and Treatment Project

et al. 2016

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“…The combination of higher lifetime risks and lower medical support place a double burden on this group. Previous studies have suggested that nationwide implementation of screening middle aged African Americans could decrease the rate of undiagnosed glaucoma from 50% to 27%(25). Earlier screening and diagnosis enables patients to more effectively leverage current treatment options to reduce the risk of bilateral blindness later in life(25).…”

Section: Genetic Epidemiology Of Poagmentioning

confidence: 99%

Primary Open-Angle Glaucoma Genetics in African Americans

Restrepo

Bailey

2017

Curr Genet Med Rep

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Purpose of review Individuals of African descent are at highest risk for developing primary open-angle glaucoma (POAG), a devastating disease and major contributor of blindness worldwide. Currently, there is a large dearth of knowledge in this area despite a critical need for better understanding the underlying genetic and environmental factors afflicting this population. Here we highlight the current literature exploring the genetics of POAG in African Americans. Recent findings Current studies have yet to replicate European POAG index variants (i.e. CDKN2B-AS1 and SIX1/SIX6) in African Americans or to definitely exclude that these loci contribute to risk in African descent populations. Recent studies have evaluated clinical features that may account for some differences in POAG risk between African Americans and European Americans. Summary In summary, little headway has been made in elucidating the genetics of primary open-angle glaucoma in African Americans and other individuals of African descent.

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“…A well-known barrier for individuals seeking medical attention is low socioeconomic status which disproportionally affects African Americans[32]. Additionally, at least one study suggests that the lifetime prevalence of undiagnosed glaucoma in African Americans is 50%[33]. This may in part explain the limited number of African American POAG cases (n = 267) representing only 2.82% of African Americans in EAGLE BioVU.…”

Section: Discussionmentioning

confidence: 99%

Extracting Primary Open-Angle Glaucoma from Electronic Medical Records for Genetic Association Studies

et al. 2015

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Electronic medical records (EMRs) are being widely implemented for use in genetic and genomic studies. As a phenotypic rich resource, EMRs provide researchers with the opportunity to identify disease cohorts and perform genotype-phenotype association studies. The Epidemiologic Architecture for Genes Linked to Environment (EAGLE) study, as part of the Population Architecture using Genomics and Epidemiology (PAGE) I study, has genotyped more than 15,000 individuals of diverse genetic ancestry in BioVU, the Vanderbilt University Medical Center’s biorepository linked to a de-identified version of the EMR (EAGLE BioVU). Here we develop and deploy an algorithm utilizing data mining techniques to identify primary open-angle glaucoma (POAG) in African Americans from EAGLE BioVU for genetic association studies. The algorithm described here was designed using a combination of diagnostic codes, current procedural terminology billing codes, and free text searches to identify POAG status in situations where gold-standard digital photography cannot be accessed. The case algorithm identified 267 potential POAG subjects but underperformed after manual review with a positive predictive value of 51.6% and an accuracy of 76.3%. The control algorithm identified controls with a negative predictive value of 98.3%. Although the case algorithm requires more downstream manual review for use in large-scale studies, it provides a basis by which to extract a specific clinical subtype of glaucoma from EMRs in the absence of digital photographs.

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Projected Clinical Outcomes of Glaucoma Screening in African American Individuals

Abstract: Routine glaucoma screening for middle-aged African American individuals is potentially clinically effective but its impact on visual impairment and blindness may be modest. However, we did not assess the impact on visual field loss.

Cited by 21 publications

References 42 publications

The Philadelphia Glaucoma Detection and Treatment Project

The Philadelphia Glaucoma Detection and Treatment Project

Primary Open-Angle Glaucoma Genetics in African Americans

Extracting Primary Open-Angle Glaucoma from Electronic Medical Records for Genetic Association Studies

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