Association of Neighborhood Environment with the Outcomes of Childhood Glaucoma

To determine the association between different neighborhood environment factors and the outcomes of childhood glaucoma.A retrospective cohort.Childhood glaucoma patients ≤18 years of age at the time of diagnosis.A retrospective chart review of childhood glaucoma patients who presented to Boston Children's Hospital between 2014 through 2019. Data collected included etiology, intraocular pressure (IOP), management, and visual outcomes. Child Opportunity Index (COI) was used as a metric of neighborhood quality.The association of visual acuity (VA) and IOP with COI scores using linear mixed-effect models, adjusting for individual demographics.A total of 221 eyes (149 patients) were included. Of these, 52.3% were females, and 56.4% were non-Hispanic Whites. The median age at the time of presentation was 5 months for primary glaucoma and 5 years for secondary glaucoma. The median age at the last follow-up was 6 and 13 years for primary and secondary glaucoma, respectively. A chi-square test revealed that the COI, health &environment, social & economic, and education indexes between primary and secondary glaucoma patients were comparable. For primary glaucoma, the overall COI and a higher education index were associated with a lower final IOP (P<0.05), and higher education index was associated with a lower number of glaucoma medications at the last follow-up (P<0.05). For secondary glaucoma, higher overall COI, health & environment, social & economic, and education indices were associated with better final VA (lower logMAR VA) (P<0.001).Neighborhood environment quality is a potentially important variable for predicting outcomes in childhood glaucoma. Lower COI scores were associated with worse outcomes.