Visual Field Progression Rate and Laminar Depth in the African Descent and Glaucoma Evaluation Study (ADAGES)

Abstract

Purpose : To determine whether lamina cribrosa (LC) depth is a risk factor for visual field progression in primary open angle glaucoma (POAG).

Methods : Longitudinal OCT radial scans from 1,362 eyes of 744 participants in the African Descent and Glaucoma Evaluation Study (ADAGES) and Diagnostic Innovations in Glaucoma Study (DIGS) were included. Clustered random sampling was performed to reduce the impact of age and disease severity imbalance across race. Data from patients undergoing incisional glaucoma surgery was censored at the date of the surgical intervention. LC depth was computed based on automated segmentation (Reflectivity, Abyss) and reviewed by masked observers. Univariable and multivariable linear mixed-effects models were performed to test the association between LC depth and progression of the visual field.

Results : 9,397 of 10,535 radial scans were graded as reporting accurate deep tissue automated segmentation and were included in the analysis. Univariable models revealed significant associations with age, race, intraocular pressure (IOP), corneal thickness and LC depth with visual field progression. Multivariable analysis (table) revealed independent associations between race, with a greater decrease in MD in the African descent group, mean (SE) [0.2 (0,07) dB/year, p = 0.002], IOP (0.07 dB/year greater decrease in MD/2mmHG IOP, SE = 0.07, p < 0.001) and LC depth (0.07 dB/year greater decrease in MD/50 micron deeper LC, SE = 0.02, p < 0.001).

Conclusions : This study demonstrated that lamina depth is independently predictive of visual field progression in glaucoma patients. These results suggest that pathologic and/or age-related posterior remodeling of the lamina cribrosa may contribute to the risk of continued glaucomatous injury.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.