Advanced Vision Loss After Glaucoma Diagnosis More Likely Among Black Patients

Black patients have a significantly higher risk of advanced vision field (VF) loss after a diagnosis of primary open-angle glaucoma (POAG) when compared with White patients, according to a recent study.

To investigate the racial and ethnic differences in POAG, the researchers conducted a cohort study which included 209,036 participants aged 40 years or older. Data were drawn from the Nurses’ Health Study (1980 – 2008), the Nurses’ Health Study II (1989 – 2019), and the Health Professionals Follow-Up Study (1986 – 2018). Prior to the study, participants were free of glaucoma. They were followed biennially.

The researchers took note of controls such as family history, diabetes, hypertension, BMI, and socioeconomic status.

Of the total participants in the study, 1946 were diagnosed with POAG with reproducible VF loss. The researchers analyzed data from the earliest record of VF loss for each POAG eye (n = 2564). The researchers identified 14 archetypes for regional VF loss patterns—4 advanced loss patterns, 9 of early loss, and 1 of no VF loss.

When compared with White participants, Black participants had a higher risk of early VF loss archetypes (HR = 1.98; 95% CI, 1.48 – 2.66) with an even higher risk for advanced loss archetypes (HR = 6.17; 95% CI, 3.69 – 10.32; P-contrast = .0002). No differences were observed for Asian participants or Hispanic patients.

Overall, the researchers found that Black participants had a significantly higher risk of all advanced loss archetypes and 3 early loss patterns.

“The subtyping of glaucoma using machine-learning–based approaches and identifying unique risk factors may help researchers fine-tune and improve the discovery of POAG risk factors,” the researchers concluded.


—Jessica Ganga


Kang JH, Wang M, Frueh L, et al. Cohort study of race/ethnicity and incident primary open-angle glaucoma characterized by autonomously determined visual field loss patterns. Transl Vis Sci Technol. 2022;11(7):21. doi:10.1167//tvst.11.7.21.