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

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.
How to Cite This Article: Shalaby WS, Arbabi A, Myers JS, et al. Sociodemographic and Economic Factors in Outcomes of Tube Shunts for Neovascular Glaucoma. J Curr Glaucoma Pract 2021;15(2):70-77.
Competing Interests: Source of support: American Glaucoma Society Mentoring for Advancement of Physician Scientists Grant (AGS). Conflict of interest: None
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