AI Identifies Black Patients As More Likely to Have Vision Loss After Glaucoma

Black patients have a higher risk of vision loss after a new diagnosis of primary open angle glaucoma compared with White patients, according to a new study published recently in Translational Vision Science and Technology.

Primary open angle glaucoma results in optic nerve damage and is associated with open, normal appearing anterior chamber angle and raised intraocular pressure (IOP). Glaucoma is a leading cause of blindness in the United States.

This study used an artificial intelligence algorithm to break down visual field loss in new-onset glaucoma cases among United States-based population groups.

Louis R. Pasquale, M.D.

“This study has tremendous implications for glaucoma screening of Blacks, who we already knew were a population at increased risk of glaucoma,” senior author Louis R. Pasquale, M.D., deputy chair for Ophthalmology Research at the Icahn School of Medicine at Mount Sinai and director of the NYEE Eye and Vision Research Institute, said in a press release. “Screening earlier in life could significantly increase the chance of detecting glaucoma and slowing down progression before it reaches one of the advanced patterns shown in our research.”

Researchers at the New York Eye and Ear Infirmary of Mount Sinai (NYEE) analyzed almost 210,000 participants from three population-based databases of nurses and health professionals from the Nurses’ Health Study, and the Health Professionals Follow-up Study. None of the participants had glaucoma at baseline. They were followed biennially.

Of those being followed, 1,946 patients developed glaucoma. Black patients made up 1.3% of the study, but had a nearly twofold increased risk of early visual field loss archetypes, and a sixfold higher risk for advanced field loss archetypes, when compared with White patients. Asian participants, who constituted 1.2% of the participants, had a nearly two-fold higher risk of early visual field loss compared with white patients, but did not have a dramatically higher rate of advanced patterns of visual field loss. Hispanic patients made up 1.1% of the study population, and did not have an increased risk of any archetypes compared with white patients.

Researchers speculated that the reason why Blacks presented with more advanced patterns of loss is because the disease starts one to two decades earlier in this patient group.

There were several limitations of the study, including the reliance on questionnaires and medical health records for disease severity, a low number of racial minorities in the study means that confidence intervals were wide for certain estimates.

This study was done with collaborators at Brigham and Women’s Hospital and Massachusetts Eye and Ear. This work was supported by the National Eye Institute, part of the National Institutes of Health.