April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Differences in the Relationship Between Ocular Blood Flow, Retinal Structural Damage and Visual Field in Caucasian versus African American Glaucoma Patients
Author Affiliations & Notes
  • Sally Primus
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Alon Harris
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Brent A. Siesky
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Yochai Z. Shoshani
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Drew Davis
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Leslie Abrams
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Louis B. Cantor
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Chi-Wah R. Yung
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • John Abrams
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Mohammadali M. Shoja
    Ophthalmology, Indiana Univ Sch of Medicine, Indianapolis, Indiana
  • Footnotes
    Commercial Relationships  Sally Primus, None; Alon Harris, Pfizer (C); Brent A. Siesky, None; Yochai Z. Shoshani, None; Drew Davis, None; Leslie Abrams, None; Louis B. Cantor, Allergan (C); Chi-Wah R. Yung, None; John Abrams, None; Mohammadali M. Shoja, None
  • Footnotes
    Support  Unrestricted grant from Research to Prevent Blindness and Pfizer Pharmaceuticals
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5061. doi:
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      Sally Primus, Alon Harris, Brent A. Siesky, Yochai Z. Shoshani, Drew Davis, Leslie Abrams, Louis B. Cantor, Chi-Wah R. Yung, John Abrams, Mohammadali M. Shoja; Differences in the Relationship Between Ocular Blood Flow, Retinal Structural Damage and Visual Field in Caucasian versus African American Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5061.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To assess differences in predictors of visual field progression between Caucasians and African Americans with open angle glaucoma (OAG) based on the Indianapolis Glaucoma Progression Study.

Methods: : 113 patients (age 66.9 (10.0), 68 females, 84 Caucasians; 29 African Americans) with OAG participating in the Indianapolis Glaucoma Progression Study were assessed for retinal nerve fiber layer (RNFL) thickness, retinal microcirculation, retrobulbar blood flow, intraocular pressure (IOP), ocular perfusion pressure (OPP) and visual field progression. Data were analyzed by Mann-Whitney U test and Spearman rank-correlation test. Rank-transformed data were used for multivariate linear regression analysis.

Results: : There were no statistically significant differences between Caucasian and African-American OAG patients with respect to age, gender, IOP, OPP, peak systolic (PSV) and end-diastolic (EDV) blood flow velocities of ophthalmic artery (OA), central retinal artery (CRA), and nasal and temporal posterior ciliary arteries (NPCA and TPCA). Mean RNFL thickness and cross-sectional area was higher in African-Americans than in Caucasians (P=0.051 and P=0.014, respectively) as was inferior retinal blood flow (P=0.011). In bivariate analysis, mean RNFL thickness and cross-sectional area negatively correlated with age (P=0.009 and P=0.020, respectively) and positively correlated with CRA EDV (r=0.238, P=0.029 and r= 0.291 P=0.008, respectively) and NPCA EDV (r= 0.381, P<0.001and r= 0.346, P=0.001, respectively) among Caucasians. In African-American OAG patients, mean RNFL thickness and cross-sectional area correlated positively and significantly only with mean superior retinal flow (r=0.47, P=0.009). Multivariate linear regression analysis revealed that mean RNFL thickness was the independent predictor of AGIS score in Caucasians (adjusted model r2=0.233) (partial rho=-0.477, P<0.001). IOP was the independent predictor of AGIS score among African-American patients (adjusted model r2=0.116) (Partial rho=0.397, P=0.045).

Conclusions: : Retrobulbar circulation appears to be the main determinant of RNFL thickness in Caucasains, while retinal microcirculation appears to be the main determinant of RNFL in African Americans. The relationship between the RNFL thickness, IOP and AGIS score appears to differ between Caucasian and African-American patients with OAG.

Keywords: blood supply • nerve fiber layer • visual fields 
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