Upon assessing factors associated with post-op interventions after laser peripheral iridotomy (LPI), researchers found that African Americans were more likely than Caucasians to carry a diagnosis of primary angle closure (PAC) or PAC glaucoma (PACG) at the time of LPI and were significantly more likely to be prescribed additional glaucoma medications and require glaucoma surgery after LPI.
This retrospective review evaluated 1,271 eyes of 692 subjects with narrow angles that were treated with LPI. The researchers assessed demographic and clinical factors associated with each diagnosis (PAC, PACG or PAC suspect), use of glaucoma medications at the time of LPI, and factors predictive of subsequent medical and surgical interventions.
The team found that African Americans were significantly more likely than Caucasians to have a diagnosis of PAC/PACG than PAC suspect and to already be on glaucoma medications at the time of LPI. They note that African Americans were also significantly more likely to be prescribed additional glaucoma medications after LPI and receive glaucoma surgery but were less likely to receive selective laser trabeculoplasty (SLT). They add that African Americans had a longer time to SLT than Caucasians but a shorter time to glaucoma surgery. They also discovered that there was no significant association between race and the likelihood of cataract surgery or the time to cataract surgery.
The researchers conclude that improved screening methods that target African-Americans with narrow angles are needed so that preventative interventions, such as LPI, can be performed earlier to decrease the risk of progression.
|Thompson AC, Vu DM, Cowan LA, et al. Factors associated with interventions following laser peripheral iridotomy for primary angle closure spectrum diagnoses. Ophthalmology. March 15, 2019. [Epub ahead of print].|