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C. A. Girkin, J. M. Liebmann, L. M. Zangwill, J. E. DeLeon-Ortega, C. Bowd, F. A. Medeiros, S. Jain, C. Boden, R. N. Weinreb, ADAGES Group; The African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Optic Nerve Structure. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3315.
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To compare the structure of the optic nerve and retinal nerve fiber layer (RNFL) between healthy participants of African Descent (AD; n=190) and European Descent (ED; n=194) obtained from the prospective, longitudinal, multi-center observational cohort study, ADAGES (n=1,224).
384 eyes (1/subject) (324 from ADAGES and 60 from the Diagnostic Innovations in Glaucoma Study) were included that had a normal fundus exam, normal visual fields, normal optic disc stereophotos, and an IOP <22 mmHg. Optic nerve topographic information was obtained using CSLO and OCT imaging, and RNFL thickness measurements were obtained using CSLO, OCT, and SLP imaging. Categorical variables were compared using Fisher’s exact test and continuous variables with the two-sample Student’s t-test. The least-squared method was used for adjusted comparison accounting for differences in disc area.
The areas of the optic disc and cup were larger with deeper cups in eyes from individuals with AD compared to those with ED, while the neuro-retinal rim was larger in the AD group. These differences were not significant following adjustment for differences in disc area. The Moorefield Regression Analysis (MRA) performed with high specificity (99.4% AD, 100% ED), while the Glaucoma Probability Score (GPS) showed a lower specificity in the AD group (83% AD, 89% ED; p- 0.021)
Significant differences in optic nerve morphology were seen between healthy eyes from persons of AD and ED and must be taken into account when interpreting results of diagnostic imaging in differing demographic groups. These differences are largely related to variation in optic disc area. Diagnostic methods that take into account differences in optic disc area, such as MRA, have a higher specificity in individuals of African descent.
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