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CYRIL Nii Amankwah NYANKERH, Sampson Listowell Abu, Lyne Racette; No racial differences exist in visual field test-retest variability in healthy eyes. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2463.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma patients of African descent (AD) have been shown to have higher visual field variability compared to patients of European descent (ED). This may lead to a delay in detecting progression and result in worse outcomes in this high-risk population. The aim of this study was to determine whether the differences in visual field variability between these two groups are also present in healthy eyes.
We selected 186 eyes of 92 AD and 94 ED participants with healthy eyes from the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study. Healthy eyes were defined as having a normal appearance of the optic disc on stereoscopic photographs, reliable and normal visual fields, intraocular pressure (IOP) of less than 22 mm Hg, no history of elevated IOP, and no use of glaucoma medication or surgery in either eye. Each participant had three standard automated perimetry (SAP-SITA, 24-2 pattern; Carl Zeiss Meditec, Dublin, CA, USA) tests taken within a one-year period. Each test was separated by at least 7 days. Differences in test-retest variability (TRV) between the AD and ED groups were assessed using a two-factor mixed ANOVA, in which race served as the between-subject variable and the mean deviation (MD) of the visual field tests served as the repeated measures variable.
The mean (SD) age at baseline for the AD and ED groups was 47.6±17.2 and 55.4±13.4 (t= -3.454, p<0.001). Figure 1 shows Bland-Altman plots for the AD and ED groups. Collapsing over the two race groups, a significant difference of MD was observed F (2,183) = 7.241, p = 0.001. Pairwise comparisons showed significance only between visits 1 (mean MD = -1.24dB) and 3 (mean MD = -0.89dB) (p=0.001) after adjusting for multiple comparisons using the Holm-Bonferroni test. There was no significant effect of race F (1,184) = 1.01, p=0.32, and no interaction between race and TRV, F (2,183) = 0.93, p=0.40.
Participants of AD and ED with healthy eyes have similar visual field variability on SAP. This suggests that the increased variability in visual fields observed in glaucoma patients is likely due to factors other than race itself, including disease severity and demographic factors such as socioeconomic status and access to care.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Figure 1. Bland–Altman plots showing similar TRV in MD values of AD and ED eyes.
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