June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
The African Descent and Glaucoma Evaluation Study (ADAGES): Racial differences in rate of change of SD-OCT measured minimum rim width and retinal nerve fiber layer thickness
Author Affiliations & Notes
  • Christopher Bowd
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Linda M Zangwill
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Christopher A Girkin
    Department of Ophthalmology, University of Alabama, Birmingham, Birmingham, Alabama, United States
  • Jeffrey M Liebmann
    Columbia University Medical Center, Columbia University, New York, New York, United States
  • Robert N Weinreb
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Akram Belghith
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Christopher Bowd, None; Linda Zangwill, Carl Zeiss Meditec (F), Heidelberg Engineering (F), Optovue (F), Topcon (F); Christopher Girkin, None; Jeffrey Liebmann, Alcon (C), Allergan (C), Bausch & Lomb (C), Bausch & Lomb (F), Carl Zeiss Meditec (C), Carl Zeiss Meditec (F), Heidelberg Engineering (C), Heidelberg Engineering (F), Optovue (F), Reichert (C), Reichert (F), Topcon (F), Valeant Pharmaceuticals (C); Robert Weinreb, Aerie Pharmaceutical (C), Alcon (C), Allergan (C), Bausch & Lomb (C), Carl Zeiss Meditec (F), Eyenovia (C), Foresight Vision (C), Genentech (F), Heidelberg Engineering (F), Optovue (F), Quark (F), Sensimed (C), Topcon (F), Unity (C); Akram Belghith, None
  • Footnotes
    Support  NIH R01EY022039, NIH R01EY011008, R01EY019869, R01EY018926, R01EY023704, P30EY022589, participant retention incentive grants in the form of glaucoma medication at no cost from Alcon Laboratories Inc., Allergan, Pfizer Inc., and Santen Inc., and an unrestricted grant from Research to Prevent Blindness, New York, New York
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1585. doi:
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      Christopher Bowd, Linda M Zangwill, Christopher A Girkin, Jeffrey M Liebmann, Robert N Weinreb, Akram Belghith; The African Descent and Glaucoma Evaluation Study (ADAGES): Racial differences in rate of change of SD-OCT measured minimum rim width and retinal nerve fiber layer thickness. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1585.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Considerable evidence suggests that the rate of change of structural measurements in glaucoma eyes depends on risk factors such as race, IOP, age and disease severity. We investigated whether race-related differences exist in the rate of change of minimum rim width (MRW) and circumpapillary retinal nerve fiber layer thickness (RNFLT) in healthy, glaucoma suspect and glaucoma eyes of individuals of European descent (ED) and African descent (AD).

Methods : Rate of change of MRW and RNFLT was investigated in 120 healthy eyes (60 ED, 60 AD), 239 glaucoma suspect eyes (102 ED, 137 AD) and 175 glaucoma eyes (82 ED, 93 AD) of ADAGES participants followed for approximately 3 years and tested with Spectralis spectral domain OCT (Heidelberg Engineering) approximately every 6 months. Suspect eyes were defined as those with a history of untreated IOP ≥ 22 mmHg or suspicion of glaucoma by masked assessment of stereoscopic optic disc photographs with no consecutive, repeatable abnormal standard automated perimetry results (SAP, Carl Zeiss Meditec). Glaucoma eyes were defined as eyes with repeatable abnormal SAP results (GHT ONL or PSD ≤ 5%). The San Diego Automated Layer Segmentation Algorithm (SALSA) was used to segment and measure global MRW and RNFLT from OCT images. Mixed effects models were used to estimate the rate of change after controlling for age and optic disc size

Results : After an average of 2.7 years follow-up, a significant race-related difference in rate of change of MRW but not RNFLT in suspect eyes was observed. Rate of change of MRW was -1.85 μm/year and -2.20 μm/year in ED and AD eyes, respectively (p =0.03, see Figure). Rate of change of RNFLT was -0.48 μm/year and -0.49 μm/year in ED and AD eyes, respectively (p =0.90). No race-related differences in rate of change were found in measurements from healthy or glaucoma eyes. In suspect eyes, age and SAP MD were similar in the ED and AD groups at baseline (p ≥0.05). However, average IOP over study duration was significantly higher in AD eyes (p <0.001).

Conclusions : Results indicate that race is an important consideration when assessing structural change in glaucoma, particularly in glaucoma suspect eyes. Observed racial differences in rate of structural change may help explain racial disparities in glaucoma susceptibility.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

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