ArticleAmerican journal of ophthalmology2024
Association Between Greater Social Vulnerability and Delayed Glaucoma Surgery.
Article in American journal of ophthalmology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Vision in the margins: the association between census tract neighbourhood disadvantage and visual difficulty and blindness in the United States.Eye (London, England) · 2026Article
- Primary Open-Angle Glaucoma among Black and Latinx Populations: Exploring Racial Disparities in the United States.Journal of racial and ethnic health disparities · 2026Review
- Area Deprivation and Social Vulnerability Are Associated with Pediatric Vision Screening Outcomes in the University of California, Irvine EyeMobile Program.Eye (London, England) · 2026Article
- Inefficacy of Longitudinal Cup-to-Disc Ratio Measurements in Identifying Glaucoma Progression.American journal of ophthalmology · 2025Article
- Association Between Sociodemographic Risk Factors and No-Show Propensity in a Glaucoma Population Before and During COVID-19 Pandemic.Journal of glaucoma · 2025Article
- Impact of Physiological and Psychological Stress on Glaucoma Development and Progression: A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
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Authors and funding
3 authors.
Funding
Abstract
purposeTiming of surgical intervention in glaucoma is crucial to preserving sight. While ocular characteristics that increase surgical risk are known, the impact of neighborhood-level social risk factors such as the Social Vulnerability Index (SVI) and Area Deprivation Index (ADI) on time to glaucoma surgery is unknown. The objective of this study was to evaluate the association between SVI or ADI scores and the timing of glaucoma surgical intervention.
designRetrospective cohort study.
methodsAdult subjects with open-angle glaucoma were identified from the Bascom Palmer Glaucoma Repository using International Classification of Disease-10 codes. Subject demographics, ocular characteristics, and standard automated perimetry data were extracted. Geocoded data were obtained using subject residences and American Community Survey data. Univariable and multivariable time-to-event survival analyses using accelerated failure time models were completed to evaluate whether geocoded SVI and ADI scores accelerated or delayed time to glaucoma surgery from initial glaucoma diagnosis in the electronic health record.
resultsA total of 10,553 eyes from 6934 subjects were evaluated, of which 637 eyes (6.0%) from 568 subjects (8.2%) underwent glaucoma surgery. Mean age was 68.3 ± 13.5 years, with 57.9% female, 21.5% Black, and 34.5% Hispanic subjects. Mean follow-up time was 5.0 ± 2.1 years, with time to surgery of 3.2 ± 1.9 years. Multivariable accelerated failure time models demonstrated that higher mean intraocular pressure (time ratio [TR] 0.27 per 5 mm Hg higher; 95% confidence interval [CI]: 0.23-0.31, P < .001), faster standard automated perimetry rate of progression (TR 0.74 per 0.5 dB/year faster; 95% CI: 0.69-0.78, P < .001), moderate (TR 0.69; 95% CI: 0.56-0.85, P < .001) or severe baseline severity (TR 0.39; 95% CI: 0.32-0.47, P < .001), and thinner central corneal thickness (TR 0.85 per 50 µm thinner; 95% CI: 0.77-0.95, P = .003) all accelerated time to surgery. In contrast, overall SVI delayed surgery (TR 1.11 per 25% increase; 95% CI: 1.03-1.20, P = .006). Specifically, SVI Themes 1 (TR 1.08; 95% CI: 1.01-1.17, P = .037) and 4 (TR 1.11; 95% CI: 1.03-1.19, P = .006) were significant. Patients from the most deprived neighborhoods (highest national ADI quartile) had a 68% increase in time to surgery compared to the least deprived quartile (TR 1.68; 95% CI: 1.20-2.36, P = .002).
conclusionsResidence in areas with higher SVI or ADI scores was associated with delayed glaucoma surgery after controlling for demographic and ocular parameters. Awareness of such disparities can guide initiatives aimed at achieving parity in health outcomes.
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