Racial Disparities in Glaucoma Vision Outcomes and Eye Care Utilization: An IRIS Registry Analysis.

Area of Science:

• Ophthalmology and Public Health
• Health Services Research
• Health Disparities Research

Background:

• Racial and ethnic minorities face significant health disparities in the United States.
• Glaucoma, a leading cause of irreversible blindness, disproportionately affects certain minority populations.
• Understanding vision outcomes and eye care utilization across different racial and ethnic groups is crucial for addressing these disparities.

Purpose of the Study:

• To evaluate racial and ethnic disparities in vision outcomes among glaucoma patients.
• To assess disparities in eye care utilization and disease monitoring within the glaucoma patient population.
• To identify potential undertreatment of glaucoma in racial and ethnic minority groups.

Main Methods:

• A retrospective cohort study utilizing the IRIS Registry (Intelligent Research in Sight) database.
• Inclusion of patients with a glaucoma diagnosis prior to January 1, 2015, and at least one eye exam or related procedure in 2015.
• Multivariable regression models were employed to analyze vision outcomes (e.g., cup-to-disc ratio progression, poor vision) and utilization outcomes (e.g., eye exams, OCTs, VFs) across racial and ethnic groups from 2015 to 2020.

Main Results:

• Non-Hispanic Black and Hispanic patients exhibited higher odds of cup-to-disc ratio progression, poor vision, and glaucoma filtering surgery compared to White patients.
• Hispanic patients had increased odds of low vision diagnoses, while Black and Hispanic patients were less likely to undergo eye exams and optical coherence tomography (OCT) scans.
• Native American patients showed higher odds of poor vision and reduced utilization of outpatient visits, OCTs, visual fields, and surgeries compared to White patients.

Conclusions:

• Significant racial and ethnic disparities persist in vision outcomes and eye care utilization for glaucoma patients in the US.
• Black, Hispanic, and Native American populations experience worse vision outcomes and less consistent disease monitoring.
• These findings suggest potential undertreatment of glaucoma in minority groups, elevating their risk of vision loss and emphasizing the need for targeted interventions.