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C.A. Girkin, G. McGwin, C. Long, J. DeLeon–Ortega, C.M. Graff, A.W. Everett; Discrimination Between Glaucomatous and Non–Glaucomatous Eyes in African–Americans and Whites with Subjective and Objective Optic Nerve Assessment . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5502.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To compare the ability of quantitative optic disc topography and subjective optic disc evaluation in discriminating glaucomatous from normal eyes in African Americans and Whites. Methods:118 eyes from African American patients and 86 eyes from White patients with glaucoma were included in the analysis. 112 eyes from African American normal subjects and 66 eyes from White normal subjects were used as a control group. Racial groups were defined by self–description. All subjects underwent topographic imaging, stereophotography, and standard perimetry. Glaucoma was defined by visual field defect alone. Stereophotos were graded in a masked fashion by three independent graders. The areas under the receiver operator curve (aROC) were calculated for the overall stereophoto grade, each CSLO parameter, and previously describe discriminant functions. After adjustment for disc area, the aROC associated with each parameter, discriminant function, and subjective stereophoto grade were compared between African Americans and Whites. Results:The aROC for masked stereophotographic disc evaluation and the best discriminatory CSLO parameter (vertical cup disc ratio, CDR) was higher in Whites (0.868 stereophotographic, 0.823 CSLO vertical CDR) than in African–Americans (0.831 stereophotographic, 0.788 CSLO vertical CDR). However, this difference was not significant when adjusted for disc area. No significant differences were found between the aROC with subjective stereophotographic assessment and the most discriminatory optic disc parameter in either racial group. Conclusions:Previously described racial differences in optic disc structure produce little impact on the relative ability of subjective and objective methods to discriminate between glaucomatous and non–glaucomatous optic discs.
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