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18-12-2012 | Legal medicine | Article

Ethnic disparities remain in glaucoma testing


Free abstract

medwireNews: A decade's worth of data show that Hispanic men and women are less likely than individuals of other race or ethnicity to undergo ocular imaging for glaucoma.

While the findings indicate encouraging results among Black men and women - their odds for undergoing some forms of testing increased between 2001 and 2009 - efforts need to be made to identify the barriers to glaucoma monitoring in their Hispanic peers, say the researchers.

"Difficulties with the English language and a lack of usual eye care provider or place of care are all factors that affected rates of eye care visits among participants in the Los Angeles Latino Eye Study and may also be contributing to some of the trends we observed," say Joshua Stein (University of Michigan, Ann Arbor, USA) and co-workers.

The findings emerge from data for health insurance beneficiaries who underwent any eye care during the studied period. The researchers identified and analyzed two groups of individuals diagnosed with open-angle glaucoma in 2003 (n=4139) and 2007 (n=3803).

The proportions of White, Black, Hispanic, and Asian-American patients who were diagnosed with glaucoma in 2003 but failed to undergo ancillary glaucoma testing within 24 months were 16%, 19%, 25%, and 21%, respectively.

The corresponding figures for those diagnosed in 2007 were 13%, 10%, 14%, and 15%, respectively.

Stein and colleagues found that the magnitude of decline in the probability of undergoing visual field testing between 2001 and 2009 was greatest for Hispanic men, at 24%, and Hispanic women, at 21%. By contrast, fewer Black men and women and Asian-American men missed out on such tests, with decreases of 13%, 13%, and 10%, respectively.

The likelihood for receiving fundus photographic testing did not change much for any race or ethnicity over the study period.

However, probability of undergoing "other" ocular imaging (OOI, ie, not visual field or fundus photography) increased for all, but by the smallest amount among Hispanic individuals, by 15% and 12% for men and women, respectively. The greatest increase in odds of undergoing OOI was seen among Black men and women, at 173% for each.

In an accompanying editorial, Eve Higginbotham (Association of American Medical Colleges, Washington, DC, USA) adds that, "unless we pay more attention to preventive measures such as diagnostic testing for glaucoma, we will have an increasing burden of unnecessary visual impairment."

By Sarah Guy, medwireNews Reporter

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