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Linda Zangwill, Naira Khachatryan, Sonia Jain, Feng He, Felipe Medeiros, Christopher Bowd, Renato Lisboa, Robert Weinreb, Jeffrey Liebmann, Christopher Girkin; Glaucomatous progression in the African Descent and Glaucoma Evaluation Study (ADAGES). Invest. Ophthalmol. Vis. Sci. 2013;54(15):2655.
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To evaluate predictors of glaucomatous optic disc and visual field progression in glaucoma patients.
Glaucoma patients enrolled in the African Descent and Glaucoma Evaluation Study (ADAGES) and Diagnostic Innovations in Glaucoma Study (DIGS) with repeatable visual field damage at study entry followed for at least 2 years were included. Glaucomatous progression was defined as the development of Standard Automated Perimetry (SAP) Guided Progression Analysis (GPA) “likely progression” or stereophotograph-based optic disc deterioration identified by 2 independent graders. Age, gender, race, IOP and baseline ocular risk factors including corneal thickness, stereophotograph-based vertical cup-disc ratio and visual field MD and PSD were evaluated in univariate and multivariable Cox proportional hazards models to identify predictors of glaucomatous progression.
458 eyes of 254 glaucoma patients (130 African descent and 124 European descent) were included. The median SAP MD at study entry was -3.0db (range: -30.2 db to 1.4 db). The mean follow-up time was 5.7 years (range: 2.4 to 9.5 years). 100 (39%) of the 254 glaucoma patients progressed in at least one eye. 66 of the patients developed GPA visual field changes only, 19 developed optic changes only and 15 developed both visual field and optic disc changes during the follow-up period. The mean (+ SD) time to progression was 4.8 + 1.9 years. The proportion of participants progressing was similar in African descent (50/130, 38.9%) and European descent (50/124, 40.3%) glaucoma patients. In multivariable analysis, baseline IOP and stereophotograph based vertical cup disc ratio were independently predictive of glaucomatous progression.
In this subgroup of the ADAGES cohort with glaucomatous visual field damage at study entry, a relatively large proportion of African descent and European descent glaucoma patients showed evidence of GPA visual field changes and/or optic disc change.
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