Glaucoma Cascade Screening in a High Risk Afro-Caribbean Haitian Population: A Pilot Study

• Published in: Journal of glaucoma Vol. 31; no. 7; pp. 584 - 589
• Main Authors: Chang, Ta C., Celestin, Linda, Hodapp, Elizabeth A., Grajewski, Alana L., Junk, Anna, Rothman, Adam L., Duerr, Eric R.H., Swaminathan, Swarup S., Gedde, Steven J., Young, Terri L., Wiggs, Janey, Olivier, Mildred M.G., Quintanilla, Raquel, Arrieta, Esdras, Savatovsky, Eleonore J., Vanner, Elizabeth A., Parrish, Richard K.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-07-2022
• Subjects: Adolescent; Adult; Aged; Child; Female; Glaucoma - diagnosis; Glaucoma, Open-Angle - diagnosis; Haiti - epidemiology; Humans; Intraocular Pressure; Male; Middle Aged; New Glaucoma Insights: Original Studies; Ocular Hypertension; Pilot Projects; Tomography, Optical Coherence; Young Adult; Haiti
• ISSN: 1057-0829; 1536-481X
• DOI: 10.1097/IJG.0000000000001996

Glaucoma cascade screening in first-degree relatives (FDRs) of young Haitian glaucoma patients had high yield for diagnosing manifest and suspected glaucoma in 30.8% of those screened despite modest participation.
To evaluate the outcomes of glaucoma cascade screening in FDRs (parents, siblings, and offspring) of Haitian juvenile open-angle glaucoma (JOAG) patients.
Consecutive index patients (Haitians with JOAG) were identified, and the number/type of FDRs residing in South Florida were recorded. These FDRs were invited for free glaucoma screening, which included a comprehensive ophthalmic exam, gonioscopy, automated visual field testing and optical coherence tomographic analysis of the retinal nerve fiber layers. FDR characteristics and clinical findings from screening are reported.
A total of 77 FDRs were invited, 26 (33.8%) agreed to undergo screening (18 females, 9 males), which revealed 2 (7.7%) with manifest glaucoma (mean age 77.5 y; one of whom was previously unaware of his glaucoma diagnosis), 6 (23.1%) with suspected glaucoma (mean age 29.8±18.3 y), and 18 (69.2%) without manifest or suspected glaucoma (mean age 37.2±21.8 y). Siblings of index patients were least likely to participate in cascade glaucoma screening when compared with index patients' parents or offspring. FDR eyes with manifest glaucoma had significantly worse best-corrected visual acuities, higher intraocular pressures, thinner central corneal thicknesses, and thinner circumferential papillary retinal nerve fiber layer thicknesses than those without glaucoma.
Glaucoma cascade screening of Haitian JOAG patients' FDRs revealed that 30.8% had suspected or manifest glaucoma. Future efforts centered on provider-initiated recruitment and improving public glaucoma awareness and education may increase screening participation.