Glaucoma Treatment Outcomes in Open Angle Glaucoma Patients of African Descent.

Autor:	Siesky B; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital., Harris A; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital., Belamkar A; Indiana University School of Medicine, Indianapolis, IN., Zukerman R; Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL., Horn A; Darien High School, Darien, CT., Verticchio Vercellin A; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital., Mendoza KA; New York Eye and Ear Infirmary of Mount Sinai, New York, NY., Sidoti PA; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital., Oddone F; IRCCS-Fondazione Bietti, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Journal of glaucoma [J Glaucoma] 2022 Jul 01; Vol. 31 (7), pp. 479-487. Date of Electronic Publication: 2022 Mar 29.
DOI:	10.1097/IJG.0000000000002027
Abstrakt:	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. Competing Interests: Disclosure: A.H. received remuneration from AdOM, Qlaris, Luseed, and Cipla for serving as a consultant, and he serves on the board of AdOM, Qlaris, and Phileas Pharma. A.H. holds an ownership interest in AdOM, Luseed, Oxymap, Qlaris, Phileas Pharma, SlitLed, and QuLent. All relationships listed above are pursuant to Icahn School of Medicine’s policy on outside activities. The remaining authors declare no conflict of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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