Associations among prenatal stress, socioeconomic status, and infant epigenetic aging.

Primary open-angle glaucoma (POAG) is characterized by loss of retinal ganglion cells (RGCs) and thinning of the retinal nerve fiber layer (RNFL) that lead to structural changes to the optic nerve head and visual field loss. While glaucoma progression typically occurs gradually, the disease can advance to threaten central visual function. In fact, 3.61 million people worldwide were estimated to be blind from glaucoma in 2020. Unfortunately, many glaucoma patients do not maintain consistent follow-up for monitoring and treatment of their disease. Half of POAG patients in a national cohort lapsed in care by a year or more between 2014 and 2019. Moreover, single center work has suggested that up to two-thirds of glaucoma patients who return after a lapse in care do so with disease progression or a late complication, suggesting that LTFU leads to worsening disease. One measure of worsening glaucoma progression is direct assessment of the optic nerve head over time. Assessment of the optic nerve includes an estimate of the ratio between the neuroretinal rim (disc) and the central depression (cup), summarized as a cup-to-disc ratio (CDR), which increases as glaucoma progresses. Larger increases in CDR correspond with greater degree of glaucomatous progression than smaller increases. Accordingly, changes in CDR and other optic disc characteristics have defined glaucoma progression endpoints in clinical trials.