From the Department of Ophthalmology, Massachusetts Eye and Ear/Mass General Brigham, Harvard Medical School, Boston, MA, USA (O.A.H, A.C.L, L.S, J.W.M, N.Z).
Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, Jilin, China (Q.J); Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA, USA (Q.J, Y.L, M.E, M.W, T.E).
Am J Ophthalmol. 2022 Oct;242:69-76. doi: 10.1016/j.ajo.2022.05.023. Epub 2022 May 30.
Investigate associations of race/ethnicity and preferred language with baseline glaucoma severity, VF test frequency and disease progression.
Retrospective cohort study.
Patients receiving VF testing at a tertiary eyecare center between 1998 and 2020 with self-identified race, ethnicity and preferred language were included. Outcome measures were VF MD and age at first visit, VF test frequency, VF MD progression.
Among 29,891 patients with VF measurements between 1998 and 2020, 55.1% were female, 71.0% self-identified as White/Caucasian, 14.0% as Black/African American, 7.4% as Asian and 6.4% as Hispanic, and 11.2% preferred a language other than English. Mean VF MD at presentation was worse among Black (-9.3±9.7 dB), Asian (-6.2±7.6 dB) and Hispanic (-8.3±9.3 dB) patients (vs. Whites [-5.5±7.3 dB, p<0.001] or non-Hispanics [-6.2±7.8 dB, p<0.001]). After controlling for age, gender and English proficiency, disparities in glaucoma severity at presentation were reduced, especially among Asian and Hispanic patients. Despite greater severity at presentation, Black patients had lower VF test frequency/person-years (1.07±0.53) compared to Whites (1.12±0.52, p=0.006) and worse VF MD progression (-0.43 dB/year, 95% CI -0.67 to -0.28, p<0.001). In contrast, Hispanics had a higher VF frequency vs. non-Hispanics (1.18±0.64 vs. 1.11±0.52, p<0.001), and no difference in VF progression (p=0.77).
Black, Asian and Hispanic patients had greater baseline severity vs. Whites. Unlike other groups, Black patients had a lower VF frequency vs. Whites and greater VF progression. Disparities in baseline severity were partially explained by English proficiency, especially for Asian and Hispanic patients.
研究种族/民族和首选语言与基线青光眼严重程度、VF 测试频率和疾病进展的关系。
回顾性队列研究。
纳入 1998 年至 2020 年间在一家三级眼科中心接受 VF 测试且自我认定为种族、民族和首选语言的患者。主要结局指标为 VF 的 MD 和首次就诊年龄、VF 测试频率、VF MD 进展。
在 1998 年至 2020 年间接受 VF 测量的 29891 名患者中，55.1%为女性，71.0%自认为是白种人/高加索人，14.0%是黑种人/非裔美国人，7.4%是亚洲人，6.4%是西班牙裔，11.2%更喜欢使用其他语言。与白人患者[-5.5±7.3 dB，p<0.001]或非西班牙裔患者[-6.2±7.8 dB，p<0.001]相比，黑人[-9.3±9.7 dB，p<0.001]、亚洲人[-6.2±7.6 dB，p<0.001]和西班牙裔[-8.3±9.3 dB，p<0.001]患者的 VF MD 初始值较差。在控制年龄、性别和英语熟练程度后，初诊时的青光眼严重程度差异减小，尤其是在亚洲人和西班牙裔患者中。尽管黑人患者初诊时病情更严重，但他们的 VF 测试频率/人年（1.07±0.53）低于白人患者（1.12±0.52，p=0.006），且 VF MD 进展更差（-0.43 dB/年，95%CI -0.67 至 -0.28，p<0.001）。相比之下，西班牙裔患者的 VF 检测频率高于非西班牙裔患者（1.18±0.64 比 1.11±0.52，p<0.001），且 VF 进展无差异（p=0.77）。
与白人患者相比，黑人、亚洲人和西班牙裔患者的基线严重程度更高。与其他群体不同，黑人患者的 VF 检测频率低于白人患者，且 VF 进展更快。英语熟练程度部分解释了基线严重程度的差异，尤其是对亚洲人和西班牙裔患者而言。
