The Ocular Surface Disease Clinic, the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
The Krieger Eye Institute of Sinai Hospital, Baltimore, Maryland, USA.
Ophthalmic Epidemiol. 2023 Oct;30(5):484-491. doi: 10.1080/09286586.2022.2131834. Epub 2022 Oct 6.
To investigate health disparities in racial and ethnic minorities with dry eye.
Medical records were reviewed for demographics, socioeconomic factors, treatments, and objective dry eye parameters. Race/ethnicity was self-reported as delineated by the U.S. Census. The reference group comprised of randomly selected White patients, with number equal to the largest minority group.
The study included 465 patients (157 Black, 157 White, 85 Asian, and 66 Hispanic). Compared to White (3.2%) patients, larger proportion of minorities used Medicaid or lacked health insurance (Black 8.3%, = .054; Asian 10.6%, = .019; Hispanic 18.2%, < .001). Black and Hispanic patients had lower estimated median household income than Whites (White $98,472, Black $75,554, < .001; Asian $105,503, = .088; Hispanic $86,839, = .030). Prior to presentation, fewer minority patients received prescription treatments or procedures (White 61.8%; Black 30.6%, < .001; Asian 43.5%, = .006; Hispanic 43.9%, = .014). Although at baseline visit minorities had worse mean conjunctival (White, 1.7; Black 2.2, = .136, Asian 2.4, = .022; Hispanic 2.6, = .005) and corneal staining scores (White, 1.6; Black 2.5, < .001; Asian 2.3, = .003; Hispanic 2.4, = .001), no differences were noted at final visit.
Minorities presented with worse objective dry eye parameters, and less prior dry eye care. Income and health care access may not fully explain the observed undertreatment at presentation. Differential management by eye care providers and patient attitudes warrant further investigation.
调查不同种族和民族的干眼症患者的健康差异。
对病历进行了回顾，内容包括人口统计学、社会经济因素、治疗方法和客观干眼症参数。种族/民族是按照美国人口普查的规定自报的。参考组由随机选择的白人患者组成，人数与最大的少数群体相等。
该研究共纳入 465 名患者（157 名黑人、157 名白人、85 名亚洲人和 66 名西班牙裔）。与白人（3.2%）患者相比，少数族裔患者使用医疗补助或缺乏医疗保险的比例更高（黑人 8.3%， =.054；亚洲人 10.6%， =.019；西班牙裔 18.2%， <.001）。黑人患者和西班牙裔患者的家庭收入中位数估计值低于白人（白人 98472 美元，黑人 75554 美元， <.001；亚洲人 105503 美元， =.088；西班牙裔 86839 美元， =.030）。就诊前，少数族裔患者接受处方治疗或手术的比例较低（白人 61.8%；黑人 30.6%， <.001；亚洲人 43.5%， =.006；西班牙裔 43.9%， =.014）。尽管在基线就诊时，少数族裔患者的平均结膜（白人 1.7；黑人 2.2， =.136，亚洲人 2.4， =.022；西班牙裔 2.6， =.005）和角膜染色评分（白人 1.6；黑人 2.5， <.001；亚洲人 2.3， =.003；西班牙裔 2.4， =.001）较差，但最终就诊时未见差异。
少数族裔患者的客观干眼症参数较差，且干眼症治疗的前期护理较少。收入和医疗保健的可及性可能无法完全解释就诊时观察到的治疗不足。眼科护理提供者的不同管理和患者态度值得进一步研究。
