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Nagar A, Myers S, Kozareva D, et al. Cascade screening for glaucoma in high-risk family members of African-Caribbean glaucoma patients in an urban population in London. Br J Ophthalmol. 2020;doi: 10.1136/bjophthalmol-2020-317373.
Nagar, A., Myers, S., Kozareva, D., Simcoe, M., & Hammond, C. (2020). Cascade screening for glaucoma in high-risk family members of African-Caribbean glaucoma patients in an urban population in London. The British journal of ophthalmology, . https://doi.org/10.1136/bjophthalmol-2020-317373
Nagar, Anindyt, et al. "Cascade screening for glaucoma in high-risk family members of African-Caribbean glaucoma patients in an urban population in London." The British journal of ophthalmology vol. (2020). doi: https://doi.org/10.1136/bjophthalmol-2020-317373
Nagar A, Myers S, Kozareva D, Simcoe M, Hammond C. Cascade screening for glaucoma in high-risk family members of African-Caribbean glaucoma patients in an urban population in London. Br J Ophthalmol. 2020 Dec 10; doi: 10.1136/bjophthalmol-2020-317373. Epub 2020 Dec 10. PMID: 33303425.
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Br J Ophthalmol. 2020 Dec 10; doi: 10.1136/bjophthalmol-2020-317373. Epub 2020 Dec 10.

Cascade screening for glaucoma in high-risk family members of African-Caribbean glaucoma patients in an urban population in London.

The British journal of ophthalmology

Anindyt Nagar, Sam Myers, Diana Kozareva, Mark Simcoe, Christopher Hammond

Affiliations

  1. Department of Ophthalmology, St Thomas' Hospital, London, UK.
  2. Academic Section of Ophthalmology, King's College London, London, UK.
  3. Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
  4. Academic Section of Ophthalmology, King's College London, London, UK [email protected].

PMID: 33303425 DOI: 10.1136/bjophthalmol-2020-317373

Abstract

BACKGROUND/AIMS: Cascade screening has been used successfully in relatives of patients with inherited cancers and other genetic diseases to identify presymptomatic disease. This study was designed to examine if this approach would be successful in a high-risk group: first-degree relatives (FDR) of African-Caribbean glaucoma patients resident in London.

METHODS: African-Caribbean patients (probands) with glaucoma from an inner London hospital setting in a deprived area were asked to disseminate personalised information to their FDR over the age of 30 and to arrange a free hospital-based screening. Data collected, including optical coherence tomography imaging, were reviewed by a glaucoma specialist and if glaucoma was diagnosed or suspected, local specialist referral via family doctor was made.

RESULTS: 203 probands were recruited from glaucoma clinics. 248 suitable FDR were identified as potentially eligible to attend screening. 57 (23%) FDR made contact with the research team of whom 18 (7%) attended a subsequent screening visit. No patients were diagnosed with glaucoma; one participant was diagnosed as glaucoma suspect. Reasons for poor uptake included reluctance by probands to involve their family members, and retirees spending significant time abroad.

CONCLUSION: Cascade screening of FDR of African-Caribbean glaucoma patients in inner city London was unsuccessful. Research confidentiality guidance prohibiting research teams directly contacting family members was a barrier. Greater community engagement, community-based screening and permission to contact FDR directly might have improved uptake.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: epidemiology; glaucoma; public health

Conflict of interest statement

Competing interests: None declared.

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