Journal of Current Glaucoma Practice

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VOLUME 15 , ISSUE 2 ( May-August, 2021 ) > List of Articles

ORIGINAL RESEARCH

Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma

Wesam S Shalaby, Amirmohsen Arbabi, Jonathan S Myers, Marlene R Moster, Reza Razeghinejad, L Jay Katz, Aakriti G Shukla

Keywords : Ahmed glaucoma valve, Baerveldt glaucoma implant, Glaucoma surgery, Income, Neovascular glaucoma, Race, Sociodemographic, Socioeconomic, Tube shunt

Citation Information : Shalaby WS, Arbabi A, Myers JS, Moster MR, Razeghinejad R, Katz LJ, Shukla AG. Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma. J Curr Glaucoma Pract 2021; 15 (2):70-77.

DOI: 10.5005/jp-journals-10078-1303

License: CC BY-NC 4.0

Published Online: 30-09-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Importance: Few studies have analyzed associations between sociodemographic factors and neovascular glaucoma (NVG) outcomes. Aim and background: To determine the potential impact of sociodemographic and economic factors on the NVG tube shunt surgery outcomes. Design: Retrospective, single-center, comparative case series. Participants: Consecutive patients who underwent tube shunt surgery for NVG and had ≥6 months of follow-up. Materials and methods: Regional average adjusted gross income (AGI) was determined by cross-referencing self-reported residential zip codes with average AGI per zip code supplied by the Internal Revenue Service. Two groups were created: (1) lower-income: individuals from neighborhoods with the lowest 10% of AGI (near the United States poverty line), (2) higher-income: the remaining 90% of individuals. Main outcome measures: Visual acuity (VA), intraocular pressure (IOP), and glaucoma medication number at 6 months and the most recent visit. Results: The mean annual AGI in the higher-income group (130 patients) was $69,596 ± 39,700 and the lower-income group (16 patients) was $27,487 ± 1,600 (p < 0.001). Age, sex, distance to the clinic, language, and all baseline clinical variables (including VA and IOP) were comparable between groups. Lower-income was associated with non-white race (81.3 vs 52.3%; p = 0.024). At month 6, VA in the lower-income group [median: HM (20/70–NLP)] was worse than the higher-income group [median: CF (20/25–NLP)] (log MAR VA: 2.32 ± 0.8 vs 1.77 ± 1.1; p = 0.02); these trends persisted through the most recent visit (p = 0.043). Follow-up IOP and medications were similar between groups. Conclusions and relevance: Lower-income may be associated with worse VA outcomes following NVG tube shunt surgery.


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