Looking for Causes of Glaucoma in Africa

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Farai Chideya talks with Dr. Rand Allingham, director of glaucoma services at Duke University's Eye Center, who's taking his research to the West African nation of Ghana. He hopes to find out why glaucoma disproportionately affects blacks, and whether human genes hold the answer.


I'm Farai Chideya.

Glaucoma is the leading cause of blindness and it affects about 2 percent of Americans over 40. But African-Americans suffer from glaucoma at nearly three times the rate of whites. Ophthalmologist Rand Allingham is director of the glaucoma service at Duke University's Eye Center. Now he's taking his research to the West African nation of Ghana. He hopes to find out why glaucoma disproportionately affects blacks and whether our genes hold the answer.

Welcome, Dr. Allingham.

Dr. RAND ALLINGHAM (Director, Duke University's Eye Center): Thank you.

CHIDEYA: So you're in Ghana right now talking to us. Why has your research taken you there?

Dr. ALLINGHAM: Since African-Americans--their ancestry is largely from West Africa. We felt that it would be useful to go back and study the West African population. We would like to identify the genetic causes of glaucoma in order to determine more effective treatment.

CHIDEYA: Now what have you found so far in the research? Have you found some links in the Ghanaian population that you think would be useful to African-Americans?

Dr. ALLINGHAM: We have been able to participate in a number of clinics, particularly in Ghana, both on the coastal regions and in the interior, and we've been able to see the effects of glaucoma, which are rather devastating here. Approximately 1 percent of the population is blind and largely from glaucoma. And the sad part of this is that it is an incurable form of blindness. So we've been able to assess that, in fact, glaucoma is very severe here. A majority of people who come in for treatment for their disease are blind in at least one eye if not both eyes at the time of diagnosis. And so a disease that needs to be prevented is not being. It's basically they're coming in late, which is a sad situation.

CHIDEYA: Are you trying just to find the origins of the transmission of glaucoma, or are you trying, in looking at this Ghanaian population, to find ways to prevent the transmission?

Dr. ALLINGHAM: We need to find what is the genetic cause of glaucoma. It is shared in both populations. It's somewhat easier to identify the gene here in the West African population because it is more concentrated. In the US, it is a melting pot, as we all know. There's a lot of genetic mixing, there's a lot of intermarriage between all groups in the United States. We feel that it's going to be more powerful and a more robust analysis to identify the gene here than we can in the States, and that's really why we're here. The key is that gene will be very important to all the affected populations. And actually, the likelihood is I'd be very surprised if any gene we find in this population does not, in fact, affect those in European ancestry and other populations worldwide. It's simply that it is more highly representative and it is more prevalent in this population.

CHIDEYA: And, Dr. Allingham, final question. There was recently a controversy over the FDA approving a drug specifically for African-Americans. Do you have any concerns about how your research will be interpreted as it pertains to the American population?

Dr. ALLINGHAM: The genes themselves are present in all humans. There are certain variations that may be more common in one group than the other and that will simply help us identify those at risk. I feel that this will be a benefit to all, including Europeans and Asians and others. I do not feel that this is related in any way to discrimination.

CHIDEYA: Dr. Rand Allingham directs the glaucoma service at Duke University's Eye Center.

Thank you so much for joining us, and we wish you good luck in your work.

Dr. ALLINGHAM: Thank you very much.

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