Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma.

Abstract

ImportanceFew studies have analyzed associations between sociodemographic factors and neovascular glaucoma (NVG) outcomes.Aim and backgroundTo determine the potential impact of sociodemographic and economic factors on the NVG tube shunt surgery outcomes.DesignRetrospective, single-center, comparative case series.ParticipantsConsecutive patients who underwent tube shunt surgery for NVG and had ≥6 months of follow-up.Materials and methodsRegional average adjusted gross income (AGI) was determined by cross-referencing self-reported residential zip codes with average AGI per zip code supplied by the Internal Revenue Service. Two groups were created: (1) lower-income: individuals from neighborhoods with the lowest 10% of AGI (near the United States poverty line), (2) higher-income: the remaining 90% of individuals.Main outcome measuresVisual acuity (VA), intraocular pressure (IOP), and glaucoma medication number at 6 months and the most recent visit.ResultsThe mean annual AGI in the higher-income group (130 patients) was $69,596 ± 39,700 and the lower-income group (16 patients) was $27,487 ± 1,600 (p < 0.001). Age, sex, distance to the clinic, language, and all baseline clinical variables (including VA and IOP) were comparable between groups. Lower-income was associated with non-white race (81.3 vs 52.3%; p = 0.024). At month 6, VA in the lower-income group [median: HM (20/70–NLP)] was worse than the higher-income group [median: CF (20/25–NLP)] (log MAR VA: 2.32 ± 0.8 vs 1.77 ± 1.1; p = 0.02); these trends persisted through the most recent visit (p = 0.043). Follow-up IOP and medications were similar between groups.Conclusions and relevanceLower-income may be associated with worse VA outcomes following NVG tube shunt surgery.How to cite this articleShalaby WS, Arbabi A, Myers JS, et al. Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma. J Curr Glaucoma Pract 2021;15(2):70–77.