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Background: Primary open-angle glaucoma (POAG) is characterized by gradual optic nerve damage in the setting of a normal anterior chamber angle. The burden of disease has been shown to disproportionately affect African Americans compared to White Americans. Existing research demonstrated that African Americans have a higher prevalence of POAG with worse central and peripheral visual field damage, are more likely to progress to blindness and at a faster rate, and are diagnosed approximately 10 years earlier, compared to White Americans. However, current gaps in knowledge include the identification of specific risk factors for glaucoma progression in African American patients. 

Objective: The objective of this study is to identify potential risk factors associated with faster progression of glaucoma and worse outcomes in African American patients compared to Caucasian patients. Additionally, we aim to identify baseline intraocular pressure (IOP), visual field (VF) measurements, retinal nerve fiber layer (RNFL) measurements in patients with faster progression.

Methods: This is an observational study. The study population includes African American and Caucasian patients with POAG seen in JSEI glaucoma clinics who have ≥ 6 visits and ≥ 3 years of follow-up. Patient records were obtained through the electronic health record (EHR) system and through physical charts. Collected data included age, race, IOP,  family history of glaucoma, visual acuity, central corneal thickness, refractive errors, RNFL, VF, slit lamp examination findings, fundus examination findings, history of ocular surgery, history of laser treatment, prescribed glaucoma medications, systemic diseases (hypertension or diabetes mellitus), smoking history, alcohol consumption, and body mass index. 

POAG progression was determined using pointwise linear regression (PLR), glaucoma rate index (GRI), and mean deviation (MD). Risk factor analysis was conducted using univariate and multivariate analyses for the three definitions of POAG progression. 

Results: Data analysis is still underway

Conclusions: This study aims to further characterize disparities in severity and progression of POAG in African Americans. Specifically, we seek to determine whether health disparities, such as access to care and ability to adhere to treatment for example, and/or genetic factors contribute to poorer outcomes. Ultimately, this work may help lay the groundwork for future studies to identify ways to reduce these disparities.