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Naira Khachatryan, Lucie Sharpsten, Felipe A Medeiros, Pamela A Sample, Jeffrey M Liebmann, Christopher A Girkin, Robert N Weinreb, Naama Hammel, Linda M Zangwill; The African Descent and Glaucoma Evaluation Study (ADAGES): Rate and Patterns of Rim Area Loss in Gaucoma Suspects. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4772.
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To compare the rate and patterns of rim area loss in glaucoma suspects who developed visual field damage (VFD) to those who did not develop VFD and to assess racial differences in rim loss over time.
649 eyes from 366 African (AD) or European descent (ED) glaucoma suspects enrolled in the African Descent and Glaucoma Evaluation Study (ADAGES) were included. All eyes had normal visual field at study entry. Global and sectoral rim area was measured with the Heidelberg Retina Tomograph (HRT) during follow-up. The rates of rim area thinning in AD and ED eyes developing repeatable VFD were compared to those of eyes who did not develop repeatable VFD using multivariate linear mixed-effects models.
106 eyes (16%) developed VFD during follow up period, including 41/214 (19%) eyes from 122 AD subjects and 65/435 (15%) eyes from 244 ED subjects. Mean follow-up time was 6.6±2.3 years. In univariate and multivariate analyses, the rate of global rim area loss was significantly faster in eyes developing VF damage compared with eyes not developing VF damage and did not differ by race. Specifically, in AD subjects, rates of rim loss were significantly faster in eyes developing VFD compared with eyes not developing VFD in global (multivariate mean -0.0077 mm2/year vs. -0.0040 mm2/year, P=0.024). Similarly, in ED subjects, rates of rim loss were significantly faster in eyes developing VFD compared with eyes not developing VFD in global (multivariate mean -0.0074 mm2/year vs. -0.0033 mm2/year, P=0.031). In both AD and ED subjects, the pattern of rim area loss was similar in the eyes that developed VFD and in eyes that did not; rim area loss tended to be faster in the temporal, temporal inferior and temporal superior regions than in the nasal regions.
In the ADAGES cohort, the rate of rim area loss was faster in eyes that developed VFD compared with eyes that didn't develop VFD. We did not observe racial differences in the rate of rim area loss in glaucoma suspects. Given the pattern of faster rim area loss in temporal sectors was similar in AD and ED eyes that developed VFD and those that did not, it is important to evaluate the magnitude of RA loss to help identify patients at highest risk of VFD. These results suggest that monitoring rate of rim loss may be a useful tool to identify patients at higher risk of VFD.
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