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Grant H. Moore, Christopher Bowd, Jeffrey M. Liebmann, Christopher A. Girkin, Mauro T. Leite, Felipe A. Medeiros, Robert N. Weinreb, Linda M. Zangwill; Asymmetry in Structural Measures in the African Descent and Glaucoma Evaluation Study (ADAGES). Invest. Ophthalmol. Vis. Sci. 2011;52(14):206.
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To compare the degree of inter-eye asymmetry of optic disc topography and retinal nerve fiber layer (RNFL) thickness in glaucoma patients of African descent (AD) and European descent (ED).
521 glaucoma patients with visual field defects, glaucomatous appearing optic discs or both (AD, n = 287, mean SAP MD =-4.04; ED, n = 234, mean SAP MD = -3.27) from the ADAGES and Diagnostic Innovations in Glaucoma Study (DIGS) were tested using HRT, GDx-VCC and SAP within 6 months of one another. HRT-II measurements included cup area, cup volume, rim area, rim volume, average cup depth, reference height, and rim to disk ratio. GDx-VCC measurements included average RNFL thickness. Inter-eye asymmetry was calculated as:Absolute Value ((OD Value- OS Value) / ((OD Value + OS Value) / 2))Asymmetry also was assessed in 475 healthy individuals (AD, n = 248; ED, n = 227), and 111 ocular hypertensives (AD, n = 51; ED, n = 60).
Asymmetry in AD glaucoma patients was significantly smaller than asymmetry in ED glaucoma patients for cup area (AD asymmetry = 0.279, ED asymmetry = 0.334, p = 0.0169) and cup volume (AD asymmetry = 0.419, ED asymmetry = 0.507, p = 0.0067). Asymmetry in AD patients was marginally larger than asymmetry in ED patients for average RNFL thickness (AD asymmetry = 0.103, ED asymmetry = 0.0856, p = 0.0532). Multivariate analyses including race, average optic disc area and glaucoma severity (defined as smallest SAP mean deviation OU) showed that significant race-related asymmetry remained for Cup Volume.
Although ED glaucoma patients in general had more asymmetry than AD glaucoma patients, the difference in asymmetry by race, with the exception of cup volume, was reduced after adjusting for glaucoma severity and optic disc size.
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