Social Vulnerability Associated with Frequency of Visual Field and Optical Coherence Tomography Testing in Glaucoma Patients.

Precis: Higher Social Vulnerability Index scores, limited-English proficiency and retirement/disability status were associated with lower odds of completing one visual field and optical coherence tomography/year in glaucoma patients.

Purpose: To assess the correlation between sociodemographic factors and the Social Vulnerability Index to the likelihood of not receiving one visual field testing and one retinal nerve fiber layer optical coherence tomography test per year.

Methods: Patient records with glaucoma living in Washington state from a single academic institution (2014-2021) were reviewed. Those with a single visit, an address with no Social Vulnerability Index score, or a diagnosis relating to pre-glaucoma, glaucoma-suspect, or ocular hypertension were excluded. Demographic data, Social Vulnerability Index scores, and the number of visual fields and optical coherence tomography were collected. Patients were classified as meeting testing criteria if they had at least one visual field and optical coherence tomography per year. Logistic regression was used to assess if sociodemographic factors and Social Vulnerability Index scores were associated with not meeting testing criteria.

Results: 3,971 patients were included: 1,470 (37.0%), 1,834 (46.2%), and 1,413 (35.6%), had at least 1 visual field/year, at least 1 optical coherence tomography/year, and at least 1 visual field and 1 optical coherence tomography/year, respectively. On average 0.8±0.6 visual field/year and 0.9±0.6 optical coherence tomography/year were performed. Limited English proficiency (P=0.009), being disabled/retired (P=0.003), and higher Social Vulnerability Index scores (P<0.001) were associated with higher odds of not meeting testing criteria.

Conclusions: While higher Social Vulnerability Index scores were linked to reduced odds of glaucoma testing, specific sociodemographic factors - such as limited English proficiency and retirement/disability - further reduced the odds.