Baseline risk factors that predict the development of open-angle glaucoma in a population: the Los Angeles Latino Eye Study.
OBJECTIVE
To determine which baseline sociodemographic, lifestyle, anthropometric, clinical, and ocular risk factors predict the development of open-angle glaucoma (OAG) in an adult population.


METHODS
A population-based, prospective cohort study.


METHODS
A total of 3772 self-identified Latinos aged ≥40 years from Los Angeles, California, who were free of OAG at baseline.


METHODS
Participants from the Los Angeles Latino Eye Study had standardized study visits at baseline and 4-year follow-up with structured interviews and a comprehensive ophthalmologic examination. We defined OAG as the presence of an open angle and a glaucomatous visual field abnormality and/or evidence of glaucomatous optic nerve damage in ≥1 eye. Multivariate logistic regression with stepwise selection was performed to determine which potential baseline risk factors independently predict the development of OAG.


METHODS
Odds ratios for various risk factors.


RESULTS
Over the 4-year follow-up, 87 participants developed OAG. The baseline risk factors that predict the development of OAG include older age (odds ratio [OR] per decade, 2.19; 95% confidence interval [CI], 1.74-2.75; P<0.001), higher intraocular pressure (IOP; OR per mmHg, 1.18; 95% CI, 1.10-1.26; P<0.001), longer axial length (OR per mm, 1.48; 95% CI, 1.22-1.80; P<0.001), thinner central cornea (OR per 40 μm thinner, 1.30; 95% CI, 1.00-1.70; P = 0.050), higher waist-to-hip ratio (OR per 0.05 higher, 1.21; 95% CI, 1.05-1.39; P = 0.007) and lack of vision insurance (OR, 2.08; 95% CI, 1.26-3.41; P = 0.004).


CONCLUSIONS
Despite a mean baseline IOP of 14 mmHg in Latinos, higher IOP is an important risk factor for developing OAG. Biometric measures suggestive of less structural support such as longer axial length and thin central corneal thickness were identified as important risk factors. Lack of health insurance reduces access to eye care and increases the burden of OAG by reducing the likelihood of early detection and treatment of OAG.


BACKGROUND
The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Xuejuan
X
Jiang
Rohit
R
Varma
Shuang
S
Wu
Mina
M
Torres
Stanley P
SP
Azen
Brian A
BA
Francis
Vikas
V
Chopra
Betsy Bao-Thu
BB
Nguyen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000208:ethnology*; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D007429:Intraocular Pressure; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular