Disparities in Visual Field Testing Frequency Among Subjects With Glaucoma

Area of Science:

• Ophthalmology
• Public Health
• Health Equity

Background:

• Racial disparities in healthcare are well-documented.
• Previous studies suggest inequities in visual field testing (VFT) for glaucoma patients.
• Socioeconomic factors and disease severity may influence VFT utilization.

Purpose of the Study:

• To investigate racial disparities in VFT frequency among glaucoma patients.
• To assess the impact of baseline glaucoma severity and socioeconomic disadvantage on VFT utilization.
• To control for confounders like test reliability, ancillary tests, and glaucoma surgeries.

Main Methods:

• Retrospective analysis of 2654 glaucoma patients (White, Black, Asian) from 2018-2021.
• Comparison of VFT frequency, total office visits (DoS), and VFT/DoS ratio across racial groups.
• Statistical control for sex, age, Area Deprivation Index, VF reliability, baseline mean deviation, OCT frequency, and glaucoma surgeries.

Main Results:

• Black patients had the highest socioeconomic disadvantage and disease severity at baseline.
• Black subjects showed a 3% lower VFT/DoS ratio compared to White subjects (P=0.031).
• Asian subjects exhibited a 5% lower VFT/DoS ratio compared to White subjects (P=0.015).

Conclusions:

• Racial disparities in VFT for glaucoma patients persist even after controlling for key confounders.
• Black and Asian glaucoma patients receive fewer VFTs per visit than White patients.
• Further research is needed to identify and address race-associated factors contributing to these disparities in VFT.