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Mauro T. Leite, Linda M. Zangwill, Robert N. Weinreb, Christopher Bowd, Ali Tafreshi, Kaweh Mansouri, Christopher A. Girkin, Jeffrey M. Liebmann, Pamela A. Sample, Felipe A. Medeiros; African Descent And Glaucoma Study (ADAGES): Comparison Of Rates Of Glaucomatous Progressive Nerve Fiber Layer Loss Between Patients Of European Descent And African-descent. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4167.
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To compare the rates of retinal nerve fiber layer (RNFL) loss, as measured by scanning laser polarimetry with enhanced corneal compensation (GDx ECC), in a cohort of African Descent (AD) and European Descent (ED) glaucoma and glaucoma suspect patients followed over time.
This was an observational cohort study. Three hundred and ten eyes (187 ED and 123 AD) with glaucoma or suspected of having the disease were recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Study (ADAGES). Included eyes had to have at least 4 GDx ECC images and a minimum follow-up period of 2 years. Random coefficient models were used to evaluate the relationship between changes in RNFL thickness (global, inferior and superior) over time and ancestry. Fast progression was arbitrarily defined as an average RNFL loss greater than 2µm/yr.
The average follow-up time was 3.4 years (SD:±0.71; range: 2 to 5.5 years). Average, inferior and superior RNFL thickness had a significant decrease over time in both racial groups. No statistically significant difference was detected between AD and ED for the rates of RNFL change. For the average RNFL thickness, rates of change were -0.35µm/yr for AD and -0.51µm/yr for ED (P=0.136). For the inferior RNFL thickness, rates of change were -0.29µm/yr for AD and -0.54µm/yr for ED (P=0.097). For the superior RNFL thickness, the rates of change were -0.69µm/yr for AD and -0.82µm/yr for ED (P=0.387). Considering a range of "useful" average RNFL thickness of 40µm, based on previously reported residual thickness values the mean rates of RNFL loss per year would correspond to 1.8%/yr in ED and 1.3%/yr in AD for the average thickness parameter. The proportion of patients who had fast progression was 4.8% in ED and 5.7% in AD.
RNFL thickness measurements obtained with the GDxECC showed significant decrease over time in glaucoma patients and suspects. Rates of RNFL loss were similar in AD and ED patients.
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