RISK-FACTORS FOR OPEN-ANGLE GLAUCOMA - THE BARBADOS EYE STUDY

Objective: To evaluate risk factors for open-angle glaucoma among blac k participants in the Barbados Eye Study. Design: Population-based stu dy of demographic, medical, ocular, familial, and other factors possib ly related to open-angle glaucoma. Setting and Participants: The Barba dos Eye Study included 4709 Barbados residents identified by a simple random sample of Barbadian-born citizens, 40 to 84 years of age; parti cipation was 84%. This report is based on the 4314 black participants examined at the study site; 302 (7%) met the Barbados Eye Study criter ia for open-angle glaucoma. Data Collection: A standardized protocol i ncluded applanation tonometry, Humphrey perimetry, fundus photography, blood pressure, anthropometry, and an interview. An ophthalmologic ex amination was performed for participants who met specific criteria. Ma in Outcome Measures: Open-angle glaucoma was defined by the presence o f both characteristic visual field defects and optic disc damage. Asso ciation of open-angle glaucoma with specific factors was evaluated in logistic regression analyses. Results: Age, male gender, high intraocu lar pressure, and family history of open-angle glaucoma were major ris k factors; the latter association was stronger in men than women. Lean body mass and cataract history were the only other factors related to open-angle glaucoma. Although hypertension and diabetes were common i n Barbados Eye Study participants, they were unrelated to the prevalen ce of open-angle glaucoma. However, associations were found with low d iastolic blood pressure-intraocular pressure differences and low systo lic and diastolic blood pressure/intraocular pressure ratios. Conclusi ons: In the Barbados Eye Study black population, persons most likely t o have open-angle glaucoma were older men and had a family history of open-angle glaucoma, high intraocular pressure, lean body mass, and ca taract history. These results suggest the importance of possible genet ic or familial factors in open-angle glaucoma. The role of vascular ri sk factors is consistent with our finding of low blood pressure to int raocular pressure relationships, but the results could be explained by the high intraocular pressure in open-angle glaucoma.