Visible Lamina Cribrosa Pores in Primary Open-Angle Glaucoma Patients of African Ancestry

Abstract

Purpose : Data regarding clinical, ocular, and demographic risk factor associations with the presence of visible pores in the lamina cribrosa (LC) in glaucoma subjects of African ancestry is scarce. We investigated the association of visible pores in the LC with various demographic, ocular, and clinical features in a population of African ancestry individuals.

Methods : In this cross-sectional study, subjects with primary open-angle glaucoma (POAG) were recruited to the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Stereo pairs of optic disc images were assessed by two POAAGG-certified graders for quantitative and qualitative ocular features. Differences were adjudicated by the Scheie Image Reading Center Director. We analyzed the associations of the presence of >3 visible pores in the LC with demographic, ocular, and clinical risk factors through univariable and multivariable regression models that account for inter-eye correlation using generalized estimating equations.

Results : In a multivariable analysis of 654 eyes with clinical phenotype data within 90 days of the image date (69.9% with LC pores), visible LC pores were more likely to be present in eyes with a cup-to-disc ratio (CDR) of ≥0.9 (OR 2.66, 95% CI: 1.44-4.92, p=.001), with nasalization of vessels (OR 3.05, 95% CI 1.91-4.86, p<.0001) and an optic cup shape that was cylindrical (OR=2.86, 95% CI: 1.87-4.37) or bean pot/partial bean pot shape(OR=3.40, 95% CI: 1.37-8.45) when compared to conical cups. Eyes with visible LC pores were less likely to have bayoneting vessels (OR 0.59, 95% CI: 0.37-0.96, p=.03). Subjects with visible LC pores had a higher degree of African ancestry and lower degree of European ancestry, evidenced by lower values of the ancestral component q0 (OR=0.85, 95% CI: 0.78-0.95, p=0.006 for per 0.1 increase in q0) (Table 1). Including eyes without clinical phenotype data yields similar results (Table 2).

Conclusions : In our cohort of POAG subjects, we found that higher CDR, excavated cups, nasalization of central retinal vessel trunks, and higher degrees of African ancestry were associated with the presence of visible LC pores. Our findings suggest a possible link between POAG severity and the presence of visible LC pores in this over affected population.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Table 1: Multivariable Risk Factors for LC pores (N=654)

 

Table 2: Multivariable Risk Factors for LC pores (N=2757)
*Not considering q0 and CDR