Prevalence and Factors Associated with Optic Disc Gray Crescent in the Primary Open-Angle African American Glaucoma Genetics (POAAGG) Study

Abstract

Purpose : To evaluate the prevalence and factors associated with optic disc Gray Crescent (GC) in African Americans with primary open-angle glaucoma.

Methods : Two experienced readers independently graded quantitative features of the optic disc in stereo color images, including GC (Figure 1), cup shape and depth, tilt, sloping of the retina to the outer rim border, beta peri-papillary atrophy, baring of lamina cribrosa and circumlinear vessels, bayoneting, , Cilio-retinal vessels, notching, and pallor of the disc rim. Differences were adjudicated by an ophthalmologist. Univariable and multivariable logistic regression modelling through backward variable selection were performed to identify risk factors of GC. Generalized estimating equation was used to account for the inter-eye correlation.

Results : The multivariable results are shown in the Table. Among 1437 glaucoma subjects, 272 (18.9%) had GC, including 11.7% % unilateral and 7.2% bilateral. Among 2759 eyes, 376 (14%) had GC. Adjusted Odds Ratio (aOR) with 95% CI was 0.77 (0.68, 0.87) for every age decade (p<0.001) and 1.62 (1.23,2.12) for subjects with diabetes. Among 2759 glaucoma eyes, 376 (14%) had GC. The aOR with 95% CI was 1.86 (1.41, 2.47) for stereoscopically identified disc tilt (p<0.001), 1.81 (1.41, 2.32) for sloping of the retina towards the disc outer rim (p<0.001), and 1.30 (1.01, 1.68) for vessel bayoneting (p=0.04) (Table).

Conclusions : Unilateral gray crescent is not uncommon in African Americans with open-angle glaucoma. Diabetes and several ocular features are associated with GC.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

POAAGG subjects’ optic disc with gray crescents (GC): A. Right optic disc showing a temporally located GC. B. Left optic disc with an inferior GC.