Although experts can't say why African Americans are three times as likely as whites to develop glaucoma, they now know that special eye drops can delay or even prevent the devastating disease in those most at risk.
A study conducted at 22 clinical sites, including UC Davis Medical Center, has found that participants who took daily medicine to reduce high eye pressure were half as likely to develop glaucoma as those who did not get treated.
"It represents proof that lower pressure really does make a difference in the treatment and prevention of glaucoma," said Dr. James D. Brandt, director of glaucoma service at UC Davis and a principal investigator in the study.
Equally important, Brandt said, is that for the first time a glaucoma study included a large number of African Americans, for whom the disease is the chief cause of blindness. Historically, they have been reluctant to join clinical trials, Brandt said, because of unethical and abusive medical experiments conducted on African Americans in the past.
"This shows that we are getting beyond that so people can, with confidence, enter trials that will benefit the African American community," Brandt said.
Louis Randall, a 67-year-old African American man from Sacramento, joined the trial about 10 years ago when he didn't have health insurance. He said he never worried about the trial, and appreciated the chance to get treatment for a condition that could have worsened with time. He has not developed glaucoma.
"I couldn't have asked for better people to look after me," he said. "When they thanked me for making the follow-up visits so often I expressed how grateful I was for the opportunity."
Glaucoma refers to a group of eye diseases characterized by damage to the optic nerve, which, if left unchecked, can lead to loss of peripheral vision and eventual blindness. The study, sponsored by the National Eye Institute and the National Center on Minority Health and Health Disparities, focused on the precursor to the most common form of the disease, known as ocular hypertension.
Of 1,636 study participants, 408 were African American. All had high intraocular pressure in at least one eye. They were followed, on average, for 6 1/2 years.
The study found that 8.4 percent of African American participants who got the eye drops developed glaucoma. Of those who did not receive the daily eye drops, 16.1 percent of participants developed the disease.
An earlier phase of the study concluded in 2002 that therapy was effective in whites. At that time, all study participants were offered the medicine.
In their paper, published in the June issue of the journal Archives of Ophthalmology, the authors note that the findings do not imply that the race of a patient should determine treatment decisions. Clinicians should first consider other risk factors and closely monitor patients for whom they prescribe the medication, they said.
The $30 million study was funded primarily by the National Institutes of Health with help from Merck Research Laboratories. Several companies, including Merck, donated drugs for the study.
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