June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
An autonomous algorithm shows that African and Hispanic Americans with primary open-angle glaucoma present with severe visual field loss patterns
Author Affiliations & Notes
  • Louis R Pasquale
    Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Jae H Kang
    Epidemiology, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Bernard Rosner
    Epidemiology, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Janey L Wiggs
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Mengyu Wang
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Tobias Elze
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Louis Pasquale, Emerald Biosciences (C), Eyenovia (C), Nicox (C), Twenty-twenty (C); Jae Kang, None; Bernard Rosner, None; Janey Wiggs, None; Mengyu Wang, None; Tobias Elze, None
  • Footnotes
    Support  NIH Grant EY015473
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3499. doi:
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    • Get Citation

      Louis R Pasquale, Jae H Kang, Bernard Rosner, Janey L Wiggs, Mengyu Wang, Tobias Elze; An autonomous algorithm shows that African and Hispanic Americans with primary open-angle glaucoma present with severe visual field loss patterns. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3499.

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

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Abstract

Purpose : We applied an artificial intelligence algorithm to new-onset visual field (VF) loss encountered in 3 US prospective cohorts followed for primary open-angle glaucoma (POAG). The algorithm objectively quantified VF loss into archetypical patterns. We examined self-reported race in relation to the specific archetypes (ATs) of VF loss.

Methods : Participants aged ≥40 years who without glaucoma and reported eye examinations in the Nurses Health Study (NHS) (n=75,767; 1980 to 2018), NHS2 (n=80,857 women; 1989-2019), and the Health Professionals Follow-up Study (n=36,838 men; 1986-2018) were followed. Information on demographics including race, medical conditions and lifestyle were assessed with biennial questionnaires. Incident POAG cases with reproducible VF loss were confirmed by medical record review. The earliest reliable VF for the worse eye was identified, and archetypal analysis was used to identify the optimal number of VF loss patterns. Each case was classified according to the most dominant VF loss archetype. Multivariable-adjusted relative risks (RRs) for each archetype and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression on pooled data. Major covariates included cohort, age, family history of glaucoma, census-tract based socioeconomic index, number of eye exams during follow-up, and medical history such as diabetes and hypertension. False discovery rate was used to account for multiple comparisons.

Results : Mean age was 57±10 years and 81% were women. Of the 1377 POAG cases, 1301 were Caucasian, 36 were of African descent, 21 were Asian, and 19 were Hispanic white. We observed 14 ATs (see Figure), of which 13 reflected function loss. We observed that having African descent compared to being non-Hispanic White was associated with ATs consistent with advanced glaucomatous loss: AT5→RR=2.84 (95%CI=1.26, 6.41); AT8→RR=5.35 (95%CI=1.79,16.0); AT10→RR=3.80 (95%CI=1.27,11.4); AT11→RR=3.79 (95%CI=1.32,10.9); and AT12→RR=11.43 (95%CI=3.77, 34.6). Being Asian compared to being non-Hispanic White was not significantly associated with any AT. Being Hispanic White compared to being non-Hispanic White was significantly associated with AT10 (RR=4.97; 95%CI=1.48,16.7) and AT11 (RR=6.58; 95%CI=2.56,16.9).

Conclusions : African and Hispanic Americans with POAG were more likley to present with central or advanced VF loss.

This is a 2021 ARVO Annual Meeting abstract.

 

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