Identifying risk factors for blindness from primary open-angle glaucoma by race: a case-control study.


Purpose:To examine the factors associated with blindness from primary open-angle glaucoma (POAG) among black and white patients at our institution. Patients and methods:For this retrospective, case-control study, patients legally blind from POAG ("cases") were matched on age, race, and gender with non-blind POAG patients ("controls"). Thirty-seven black case-control pairs and 19 white case-control pairs were included in this study. Clinical variables were compared at initial presentation and over the course of follow-up. Results:Black case-control pairs and white case-control pairs had similar characteristics at presentation, including cup-to-disc ratio and number of glaucoma medications. However, over the course of follow-up, black cases underwent significantly more glaucoma surgeries than matched controls (2.4 versus 1.2, p=0.001), whereas white cases and controls had no significant difference in glaucoma operations (0.9 versus 0.6, p=0.139). Our analysis found that glaucoma surgery is associated with blindness in black patients (odds ratio [OR] 1.6, 95% CI 1.1-2.2) but not in white patients (OR 1.5, 95% CI 0.7-3.2). Conclusion:Black and white case-control pairs with POAG shared similar risk factors for blindness at presentation. However, over the follow-up period, black cases required significantly more glaucoma surgeries compared to black controls, whereas there was no significant difference in surgery between white cases and controls. There was no difference in medication changes in either case-control set.





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Publication Info

Williams, Andrew M, Wei Huang, Kelly W Muir, Sandra S Stinnett, Jordan S Stone and Jullia A Rosdahl (2018). Identifying risk factors for blindness from primary open-angle glaucoma by race: a case-control study. Clinical ophthalmology (Auckland, N.Z.), 12. pp. 377–383. 10.2147/opth.s143417 Retrieved from

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Kelly Walton Muir

Associate Professor of Ophthalmology

Kelly W. Muir, MD, specializes in the medical and surgical management of glaucoma, cataracts and general eye disease. Her research focuses on optimizing the quality of care that glaucoma patients receive by improving patient education materials, studying patient and physician communication, and developing a novel eye drop bottle that makes it easier for patients to administer their glaucoma drops.  Her research has been funded by the American Glaucoma Society, the National Eye Institute, and the Veterans Health Administration. Dr. Muir also teaches medical students, residents, and fellows about glaucoma and other ophthalmologic conditions. Dr. Muir is fellowship-trained, board-certified and a member of the American Academy of Ophthalmology and American Glaucoma Society.


Sandra Sue Stinnett

Associate Professor of Biostatistics & Bioinformatics

Analysis of data for ophthalmology including observational studies and clinical trials. Assessment of reproducibility in grading measurements for ophthalmic studies. Teaching medical statistics.


Jullia Ann Rosdahl

Associate Professor of Ophthalmology

I am a glaucoma specialist at the Duke Eye Center.
My passions are teaching, caring for patients and doctors, and saving retinal ganglion cells.
My research interests include patient education and adherence, medical and surgical education, OCT imaging for glaucoma, and physician wellness.

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