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The Barbados Eye Studies

Arch Ophthalmol. 2001;119:89-95.

Objective  To measure the 4-year risk of open-angle glaucoma (OAG) in a black population.

Design  Population-based cohort study with 4 years of follow-up.

Setting  Simple random sample of residents of Barbados, West Indies, aged 40 years or older.

Participants  A total of 3427 members of the cohort (85% of those eligible).

Main Outcome Measure  Development of glaucoma visual field defects and optic disc damage, confirmed by automated perimetry, independent fundus photographic gradings, and standardized ophthalmologic examinations.

Results  The 4-year risk of OAG in black participants was 2.2% (95% confidence interval, 1.7%-2.8%), based on 67 newly developed cases of OAG. Incidence rates increased from 1.2% at ages 40 to 49 years to 4.2% at ages of 70 years or more, tending to be higher in men than women (2.7% vs 1.9%). About half of the incident cases were undiagnosed previously, and the rest were receiving OAG treatment. Of the 67 new cases of OAG, 32 had intraocular pressure of 21 mm Hg or less at baseline (1.2% incidence) and 35 had higher pressures (9% incidence). Risk was highest among persons classified as having suspect OAG at baseline (26.1%), followed by those with ocular hypertension (4.9%) and lowest in the remaining population (0.8%).

Conclusions  This longitudinal study provides new information on OAG risk, as well as the first incidence measurement in a black population. Although intraocular pressure increased risk, about half of the new cases had baseline pressures of 21 mm Hg or less. Results substantiate the high OAG risk in the population of African origin, especially in older adults; the relative role of intraocular pressure; and the considerable underdetection of new disease after 4 years of follow-up.

M. Cristina Leske, MD, MPH; Anthea M. S. Connell, FRCS, FRCOphth; Suh-Yuh Wu, MA; Barbara Nemesure, PhD; Xiaowei Li, PhD; Andrew Schachat, MD; Anselm Hennis, MRCP(UK), PhD; for the Barbados Eye Studies Group
From the Department of Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY (Drs Leske, Nemesure, Li, and Hennis; Ms Wu; and Barbados Eye Studies Group); Ministry of Health, Barbados, West Indies (Drs Connell and Hennis and Barbados Eye Studies Group); The Johns Hopkins University, School of Medicine, Baltimore, Md (Dr Schachat and Barbados Eye Studies Group); and School of Clinical Medicine and Research, University of the West Indies, Bridgetown, Barbados (Dr Hennis and Barbados Eye Studies Group).

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