Abstract
ObjectiveTo identify the major risk factors for primary open-angle glaucoma (POAG) in individuals of African descent.MethodsWe searched PubMed for relevant articles, with results spanning April 1947 to present. All abstracts were reviewed and, where relevant to POAG and race, articles were catalogued and analyzed. Additional sources were identified through citations in articles returned by our search.ResultsNumerous potential POAG risk factors were identified and organized into categories by demographics (age, sex, and skin color), lifestyle choices (smoking, alcohol), comorbidities (hypertension, diabetes, and obesity), ophthalmic findings (eye structure, central corneal thickness, corneal hysteresis, elevated intraocular pressure, myopia, cataract, and vascular abnormalities), family history, socioeconomic status, and adherence. Older age, male sex, lower central corneal thickness, decreased corneal hysteresis, elevated intraocular pressure, myopia, vascular abnormalities, and positive family history were definitively associated with increased risk of POAG.ConclusionsIndividuals at greatest risk for POAG should be screened by an ophthalmologist to allow earlier detection and to slow disease progression. Further studies on the genetics of the disease will provide more insight into underlying pathologic mechanisms and could lead to improved therapeutic interventions. Continued research in urban areas with large populations of blacks is especially needed.
Highlights
Glaucoma is the leading cause of irreversible blindness worldwide, affecting approximately 70 million people [1]
The (POAAGG) study found that African-American patients over age 80 were five times more likely to develop Primary open-angle glaucoma (POAG) than those aged 50–59
Studies examining African Caribbeans [32], Nigerians [37], and Congolese [38,39] found no significant associations between sex and POAG, but each trended toward greater risk in males
Summary
Glaucoma is the leading cause of irreversible blindness worldwide, affecting approximately 70 million people [1]. Primary open-angle glaucoma (POAG), the most common form of the disease, develops as retinal ganglion cell damage causing optic nerve degeneration with subsequent progressive, irreversible vision loss [2]. In order to improve prevention and treatment, it is important to understand the many other risk factors associated with POAG and their relationships to each other. The purpose of this review is to provide a comprehensive analysis of the major risk factors associated with POAG in individuals of African descent. Identifying POAG risk factors in black populations will improve glaucoma screening by allowing clinicians to identify individuals at greatest risk who warrant closer monitoring. Comprehensive understanding of POAG risk factors will inform data collection for large prospective studies of this population, including the Primary Open-Angle African-American Glaucoma Genetics study (POAAGG)
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