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Felipe A. Medeiros, Mauro Leite, Linda M. Zangwill, Robert N. Weinreb, Jeffrey M. Liebmann, Pamela A. Sample, Christopher A. Girkin; African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Rates of Progressive Visual Field Loss in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2117.
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To evaluate and compare rates of progressive visual field loss in a cohort of African Descent (AD) and European Descent (ED) patients diagnosed with glaucoma or suspected of having the disease.
This was an observational cohort study including 895 eyes of 520 patients (222 AD and 298 ED) with glaucoma or suspected of disease recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Study (ADAGES). Included eyes had to have at least 5 standard automated perimetry visual fields (SITA 24-2 strategy) and a minimum follow-up period of 2 years. Random coefficient models were used to evaluate the association between race and rates of visual field progression, as assessed by Mean Deviation (MD) and the Visual Field Index (VFI). Additionally, quantile regression was performed to evaluate the relationship between race and presence of fast visual field progression during follow-up.
Patients were followed for an average of 5.1 ± 1.3 years. The median number of visual fields available during follow-up was 8 (IQR: 6-10). There was no significant difference between mean rates of visual field progression in AD and ED (-0.06dB/year vs. -0.04dB/year; P = 0.626). An analysis of the racial differences in the quantiles of the distributions of slopes of change, however, revealed that the AD group had a significantly higher proportion of eyes with fast progression. The 5th quantile of rates of change in AD was -0.62dB/year compared to -0.35dB/year in ED, respectively (P <0.001). For the 1st quantile, the corresponding numbers were -1.33dB/year vs. -0.65dB/year (P = 0.021). Differences between the two racial groups remained significant after adjustment for age, baseline disease severity, mean intraocular pressure during follow-up and central corneal thickness. Similar results were obtained when rates of VFI change were analyzed.
A significantly higher proportion of AD patients showed fast rates of progression compared to ED participants, suggesting that the AD population may be at significantly higher risk for development of functional impairment from glaucoma.
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