Researchers led by Ali Al-Rajhi, PhD, MPH, manager of guidelines and assessments for the American Academy of Ophthalmology (AAO), conducted a retrospective review of almost 2 million glaucoma patients to assess the characteristics of primary open angle glaucoma (POAG) in patients having a gonioscopy, as well as their IOP outcomes. Among 1,967,087 POAG patients taken from the IRIS Registry, 414,489 (21%) received a gonioscopy within 1 year after diagnosis. In adjusted models, younger patients and those of Asian, Black/African, and Latino/Hispanic ethnic or racial groups were more likely to receive a gonioscopy. Patients’ demographics and clinical characteristics were assessed at 1 year for gonioscopy per AAO’s guidelines. Those patients with a gonioscopy within 1 year were less likely to have worsening IOP at follow-up. Worse baseline IOP was also associated with higher IOP at 1 year.

“We found most patients (79%) did not receive a gonioscopy within 12 months of their earliest POAG diagnosis and were 26% more likely to have higher IOP than patients who complied to gonioscopy recommendations,” said Dr. Al-Rajhi in a news release. Demographic characteristics associated with gonioscopy-compliant patients were younger age and specific ethnic or racial groups (Asian, Black/African, Latino/Hispanic) vs White patients. Asian and Latino/Hispanic ethnic or racial groups reported lower IOP at 1 year compared to White patients.

Dr. Al-Rajhi added that, although the study had limitations (ie, the retrospective nature of registry data collection vs standardized clinical-trial data-collection methods), the findings should encourage ophthalmologists to follow PPP recommendations for advising a gonioscopy to their patients. Gonioscopy is indicated when there is a suspicion of an angle-closure component, anterior-chamber shallowing, or anterior chamber angle abnormalities or if there is an unexplained change in IOP. Gonioscopy should be performed periodically.