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Qingying Jin, Omar Halawa, Yangjiani Li, Mohammad Eslami, Saber Kazeminasab, Mojtaba Fazli, Vishal sharma, Nazlee Zebardast, Mengyu Wang, Tobias Elze; Glaucomatous progressive retinal nerve fiber layer thinning and its association with patient race. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2423 – A0357.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate predictors of retinal nerve fiber layer (RNFL) thinning over time and their association with patient race.
From Mass. Eye and Ear glaucoma service, all patients with at least four reliable (signal strength ≥ 6) Cirrus spectral-domain optical coherence tomography (OCT) peripapillary scans over a minimum period of 2.5 years and an electronically available, questionnaire based self-reported race as either Asian, Black, or White were selected. Patient race, age and sector-specific circumpapillary RNFL thickness (cpRNFLT) at first visit were investigated by multivariable linear regression to predict the slope of cpRNFLT over time. To determine the best parameter combination to predict cpRNFLT slopes, the Akaike Information Criterion (AIC) was applied. A race specific sub-analysis was performed to reveal possible specific race-related impacts.
3,689 eyes of 1,959 patients (57.3% female) were selected. 159 patients identified as Asian, 395 as Black and 1,408 as White. On average, patients were followed up (mean±std) with 4.99±1.24 visits over 5.15±1.62 years with a mean follow-up interval of 1.32±0.35 years. Entire population results: Fig. 1A compares models to predict cpRNFLT slope over time from baseline. Baseline thickness was the best predictor in all sectors. Race outperformed age except for the temporal sector. In all sectors, the best model over all parameter combinations was the model with all parameters, where higher baseline age and lower baseline thickness were related to faster RNFL thinning over time. Race specific sub-analyses: With the exception of the temporal RNFLT slope (not shown on figures), there was a significant (ANOVA, p<0.01) main association between race and all parameters. Black patients are younger at first visit and have thicker baseline RNFL (Fig. 1B,C), but are nevertheless subject to faster RNFL thinning than the other races (Fig.2).
While models based on the entire population identified higher baseline age and thinner baseline RNFL as predictors for faster future RNFL thinning, the race-specific sub-analysis revealed an opposite effect for the group of Black patients alone, who presented at significantly younger ages and with thicker RNFL at their first visits but where still subject to faster RNFL thinning compared to the other races.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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