To determine the incidence and prevalence rates of different glaucoma types among Asian Americans, contrast glaucoma incidence and prevalence rates for Asian Americans with other races, and evaluate the hazard of developing glaucoma among different Asian ethnicities and other races.
Retrospective longitudinal cohort study
2,259,061 beneficiaries aged ≥40 enrolled in a large, national managed-care network in the United States (US) in 2001–2007
Incidence and prevalence rates of open-angle glaucoma (OAG), narrow-angle glaucoma (NAG), and normal-tension glaucoma (NTG) were determined for the beneficiaries and stratified by race and Asian ethnicity. Cox regression analyses determined the hazard of developing OAG, NAG, and NTG for Asian Americans compared with other races and among different Asian ethnicities, with adjustment for confounding factors.
Main Outcome Measures
Multivariable hazard of OAG, NAG, and NTG among different races and Asian ethnicities.
The OAG prevalence rate for Asian Americans of 6.52% was similar to that of Latinos (6.40%) and higher than that of non-Hispanic whites (5.59%). The NAG and NTG prevalence rates (3.01% and 0.73%, respectively) were considerably higher among Asian Americans compared with each of the other races. After adjustment for confounding factors, Asian Americans had a 51% increased hazard of OAG (Hazard ratio (HR)=1.51 (95% confidence interval (CI) 1.42–1.60), a 123% increased hazard of NAG (HR=2.23 (95% CI 2.07–2.41), and a 159% increased hazard of NTG (HR=2.59 (95% CI 2.22–3.02) compared with non-Hispanic whites. Vietnamese Americans (HR=3.78, (95% CI 3.19–4.48), Pakistani Americans (HR=2.45, 95% CI 1.50–4.01) and Chinese Americans (HR=2.31, 95% CI 2.06–2.59) had considerably higher hazards of NAG while Japanese Americans (HR=4.37, 95% CI 3.24–5.89) had a substantially higher hazard of NTG, compared with non–Asian Americans.
Given the rapid rise in the number of Asian Americans in the US population, resources need to be devoted to identifying and treating glaucoma among these individuals. Eye-care providers should be aware of the increased hazard of developing OAG, NAG, and NTG among Asian Americans relative to other races. When evaluating Asian Americans, inquiring about ethnicity can provide additional information on risk of specific glaucoma types.
The authors have no proprietary or commercial interest in any materials discussed in this article.