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Jeffrey M. Liebmann, Carlos G. De Moraes, Robert Ritch, Christopher Bowd, Pamela A. Sample, Christopher A. Girkin, Felipe A. Medeiros, Robert N. Weinreb, Linda M. Zangwill, ADAGES; African Descent and Glaucoma Evaluation Study (ADAGES): Ancestry Differences in Optic Disc Hemorrhages and Beta-Zone Parapapillary Atrophy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):204.
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We investigated differences in incidence and prevalence of DH and βPPA, respectively, between eyes of people of African (AD) and European descent (ED) which could account for differences in the susceptibility to glaucoma.
Stereoscopic disc photographs of subjects with and without glaucomatous optic neuropathy (GON) followed longitudinally during the initial 24 months of ADAGES underwent masked review searching for DH and βPPA. 351 AD eyes and 467 ED eyes with GON and 584 AD and 573 ED eyes without GON were included. The number of eyes with at least one detected DH any time during follow-up and eyes with βPPA were compared between the AD and ED groups. Secondary analyses included horizontal (HCDR) and vertical cup-to-disc ratio (VCDR), age, and refractive error (spherical equivalent, SE) between groups.
A total of 21 eyes with DH and 139 eyes with βPPA were identified. ED eyes were generally older than AD eyes (p<0.001). ED eyes without GON were more myopic than AD eyes without GON (p=0.017). βPPA occurred more commonly in ED than in AD eyes, regardless of whether they had GON (p<0.001) or not (p<0.001). For GON eyes, ED eyes tended to have more DH (3.2% vs. 1.4%, p=0.11) and a greater prevalence of βPPA than AD eyes (14.7% vs. 6.2%, p<0.01). Ancestry was not associated with DH after adjusting for differences in age, SE, HCDR, and VCDR (p=0.26). However, AD was protective for βPPA even after adjusting for these covariates (OR=0.43, p=0.002). This was also true for non-GON eyes (OR= 0.22, p<0.01). Only one eye without GON (ED) had a detected DH.
Individuals of AD had lower incidence and prevalence of DH and βPPA, respectively. African ancestry was independently protective for βPPA but not DH. Similar to what has been described in age-related macular degeneration, atrophic abnormalities of the posterior retinal layers around the optic disc are less frequent in AD than ED eyes.
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