Racial Disparities in Microinvasive Glaucoma Surgery for Management of Primary Open-Angle Glaucoma: A Propensity-Matched Cohort Study

Oct 11, 2024American journal of ophthalmology

Racial Differences in Use of Microinvasive Surgery to Treat Common Open-Angle Glaucoma

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Abstract

African American patients underwent microinvasive glaucoma surgery (MIGS) at a significantly lower rate, with an odds ratio of 0.834 compared to non-African American patients.

A total of 63,418 patients with mild to moderate primary open-angle glaucoma (POAG) were analyzed.
The experimental group consisted of African American patients, while the control group included non-African American patients.
Among African American patients, 1,268 out of 31,709 underwent MIGS, compared to 1,508 out of 31,709 non-African American patients.
The findings may indicate a racial disparity in the management of POAG despite its higher prevalence among African Americans.

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PURPOSE: To evaluate racial and ethnic differences in the use of microinvasive glaucoma surgery (MIGS) for the management of mild-moderate primary open-angle glaucoma (POAG) in the United States.

DESIGN: Retrospective cohort study.

PARTICIPANTS: Patients with a diagnosis of mild or moderate POAG, as defined by Current Procedural Terminology (CPT) codes, were included. The experimental group comprised African American (AA) patients, and the control group consisted of patients without an AA designation in the TriNetX database.

METHODS: Propensity scoring was used to match cohorts for age at diagnosis, Charlson Comorbidity Index, sex, nicotine dependence, glaucoma medications, family history of POAG, body mass index, and weight. Outcome was incidence of MIGS over 1 year of follow-up. Odds ratios were calculated between cohorts.

MAIN OUTCOME MEASURE: Incidence of MIGS over 1 year of follow-up post-POAG diagnosis.

RESULTS: A total of 63,418 POAG patients were included (50% AA, 50% non-AA). AA patients were found to undergo MIGS at a significantly lower rate (1,268 of 31,709) compared with non-AA patients (1,508 of 31,709) (odds ratio 0.834, 95% CI 0.773-0.900).

CONCLUSION: Although POAG is understood to be more prevalent among African Americans, these patients display lower use of MIGS, suggesting a possible nationwide racial disparity in the management of POAG.

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Racial Disparities in Microinvasive Glaucoma Surgery for Management of Primary Open-Angle Glaucoma: A Propensity-Matched Cohort Study

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