Patient Wealth Impacts Glaucoma Control and Follow-Up, reveals JAMA study
Researchers have found in a new study that personal wealth is strongly associated with outcomes 12–18 months after a new diagnosis of primary open-angle glaucoma (POAG). Patients in the lowest wealth quartile were least likely to achieve the target intraocular pressure (IOP) reduction after a glaucoma diagnosis, whereas wealthier patients were 61% less likely to be lost to follow-up. The study was published in JAMA Ophthalmology by Maryam O. and colleagues.
Included in this study were newly diagnosed POAG adult patients with a mean age of 70 years; demographic breakdown consisted of 54% female, 32% Black, 7% Latinx, 3% Asian American, and 57% White. Researchers investigated how nonmedical factors affect whether patients achieve the US National Quality Forum target threshold of at least 15% IOP reduction and the risk of LTFU, one of the primary barriers to preventing progression of glaucoma. Wealth quartile, rural versus urban residence, and household composition were quantified for their impact on treatment outcomes using multivariable analysis.
Key Findings
Lower Wealth Linked to Poorer Outcomes:
Patients in the lowest quartile of wealth had 5- to 9-fold lower odds of achieving ≥15% IOP reduction compared with the higher quartiles.
Follow-Up Influenced by Wealth:
The wealthiest patients had 61% lower odds of LTFU (OR = 0.39; 95% CI: 0.18–0.84; P = 0.02) compared with the least-wealthy group.
Rural patients are more likely to be lost to follow-up.
Rural residence increased risk for LTFU (OR = 5.54; 95% CI: 1.13–27.08).
Household Children Linked to Better IOP Reduction:
Patients with children at home had a greater reduction in IOP, by 4 mm Hg (95% CI: 0.99–7.13; P = 0.01).
Overall, IOP reduction was achieved by the majority:
Among patients who returned for follow-up, 76% reached ≥15% IOP reduction.
This cohort study demonstrated that newly diagnosed POAG patients in the lowest wealth quartile were significantly less likely to achieve recommended IOP reduction and were far more likely to be lost to follow-up compared with higher-wealth groups. These findings emphasize a critical need for clinicians, payors, and health systems to incorporate socioeconomic considerations into glaucoma care, ensure equity in access to IOP-lowering interventions, and support consistent follow-up aligned with established clinical guidelines.
Reference:
Ige MO, French DD, Chaudhury AS, et al. Quality of Care in Patients With Newly Diagnosed Glaucoma. JAMA Ophthalmol. 2025;143(11):893–902. doi:10.1001/jamaophthalmol.2025.2995
