Dataset Information

African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Optic Disc Hemorrhage and Beta-Zone Parapapillary Atrophy.

ABSTRACT: PURPOSE:To investigate the differences in the frequency of optic disc hemorrhage (DH) and prevalence of beta-zone parapapillary atrophy (?PPA) between individuals of African descent (AD) and European descent (ED). DESIGN:Prospective, multicenter, observational cohort. PARTICIPANTS:A total of 1950 eyes of 1172 participants of the African Descent and Glaucoma Evaluation Study (ADAGES). METHODS:Stereoscopic disc photographs of subjects with and without glaucomatous optic neuropathy (GON) followed during the first 13 years of the ADAGES underwent masked review searching for DH and ?PPA. A total of 928 eyes (non-GON, 581; GON, 347) of 551 AD patients (non-GON, 334; GON, 217) and 1022 eyes (non-GON, 568; GON, 454) of 611 ED patients (non-GON, 334; GON, 277) were included. We compared the number of eyes with detected DH at any time during follow-up and eyes with ?PPA between the AD and ED groups. The analyses were then adjusted for clinical parameters using multivariable logistic regression. MAIN OUTCOME MEASURES:Differences in frequency of DH and prevalence of ?PPA. RESULTS:A total of 9395 stereoscopic disc photographs were reviewed. More ED eyes experience DH than AD eyes (49/1022 [4.8%] vs. 10/928 eyes [1.1%], respectively; P < 0.001), whereas ?PPA had higher prevalence in AD eyes (675 eyes [72%] vs. 659 eyes [64%]; P < 0.001). In the final multivariable model, after controlling for confounders, AD eyes were less likely to have at least 1 detected DH than ED eyes (odds ratio [OR], 0.21; 95% CI, 0.10-0.45; P < 0.001) but were more likely to have ?PPA than ED eyes (OR, 1.55; 95% CI, 1.12-2.14; P = 0.008). CONCLUSIONS:Subjects of ED are at higher risk for developing DH compared with AD subjects, whereas AD subjects have greater prevalence of ?PPA. These findings suggest that there are structural differences within the optic nerve complex between these groups. Further research is needed to determine whether racial differences in the frequency of DH and prevalence of ?PPA affect the likelihood of glaucomatous progression.

SUBMITTER: Skaat A

PROVIDER: S-EPMC4921256 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Optic Disc Hemorrhage and Beta-Zone Parapapillary Atrophy.

Skaat Alon A De Moraes Carlos Gustavo CG Bowd Christopher C Sample Pamela A PA Girkin Christopher A CA Medeiros Felipe A FA Ritch Robert R Weinreb Robert N RN Zangwill Linda M LM Liebmann Jeffrey M JM

Ophthalmology 20160423 7

<h4>Purpose</h4>To investigate the differences in the frequency of optic disc hemorrhage (DH) and prevalence of beta-zone parapapillary atrophy (βPPA) between individuals of African descent (AD) and European descent (ED).<h4>Design</h4>Prospective, multicenter, observational cohort.<h4>Participants</h4>A total of 1950 eyes of 1172 participants of the African Descent and Glaucoma Evaluation Study (ADAGES).<h4>Methods</h4>Stereoscopic disc photographs of subjects with and without glaucomatous opti ...[more]

PMID: 27117781

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Project description:Importance:?-zone parapapillary atrophy (?PPA) has been reported as a risk factor for glaucoma onset and progression. Previous studies have shown that the prevalence of ?PPA differs between individuals of African descent (AD) and European descent (ED). Objective:To test whether the association between the presence and progression of ?PPA vs visual field progression of glaucoma differs between these 2 ancestry groups. Design, Setting, and Participants:In a prospective, multicenter, longitudinal cohort study, 634 individuals (1090 eyes) enrolled in the African Descent and Evaluation Study (ADAGES) with a diagnosis of glaucomatous optic neuropathy (GON) or ocular hypertension (OHT) and at least 2 disc stereophotographs were included. Two graders masked to clinical and ancestry data reviewed and graded the baseline and last disc stereophotographs for the presence of ?PPA at baseline and ?PPA progression (development or enlargement). Mixed-effects linear models were tested with visual field mean deviation as a dependent variable and time (alone and with interaction terms) as independent variables. ADAGES enrollment began in January 2003 and ended in July 2006; follow-up ended in 2016. Exposures:Disc stereophotographs. Main Outcomes and Measures:Progression of ?PPA in AD and ED individuals. Results:In 634 patients, a total of 814 eyes of AD (395 eyes) and ED (419) patients with GON and 276 eyes of AD (106) and ED (170) patients with OHT who were enrolled in ADAGES were analyzed. There were 336 (53.0%) women in the study; mean (SD) age was 61.9 (12.7) years. In the OHT group, the association between ?PPA at baseline and visual field progression was not significantly different between AD and ED eyes (??=?0.071; 95% CI, -0.016 to 0.158; P?=?.11), nor was the association between ?PPA progression and visual field progression (??=?0.020; 95% CI, -0.465 to 0.506; P?=?.93). In the GON group, ED eyes with baseline ?PPA progressed faster than did AD eyes with baseline ?PPA (??=?-0.124; 95% CI, -0.241 to -0.007; P?=?.04), although the association between ?PPA progression and visual field progression did not differ significantly between race groups (??=?-0.101; 95% CI, -0.323 to 0.119; P?=?.37). Conclusions and Relevance:Race had a significant effect on the association between baseline ?PPA and rates of visual field progression in eyes with GON. Progression of ?PPA was not associated with faster visual field progression in either racial group.

Project description:To investigate optic disc hemorrhage (DH)'s clinical implications to subsequent progression of primary open-angle glaucoma (POAG) in cases of mild-to-moderate myopia.Retrospective comparative study.(1) Fifty-nine (59) myopic (26.5 mm > axial length [AXL] ? 24.0 mm) POAG patients with DH and (2) 59 age-, AXL-, and mean deviation (MD) of visual field (VF)-matched controls without DH were evaluated over the course of a minimum 3.5 years of follow up. For clear assessment of the effect of DH on progression of glaucoma, the patients selected for inclusion in the study were those with stable IOP (i.e., those showing an at least 20% reduction relative to the baseline IOP) whose IOP-lowering medication was not increased, supplemented or changed during the follow-up period.The patients' optic disc/retinal nerve fiber layer (RNFL) photographs were independently evaluated by three glaucoma specialists for structural progression of glaucoma. Event-based analysis with Guided Progression Analysis (GPA) software was used to determine their functional progression. The durations of structural and functional progression were compared by Kaplan-Meier life survival analyses.Optic disc/RNFL progression and VF progression.The mean follow-up periods between the DH and non-DH groups were not significantly different: in the DH group, 5.6±2.7 years; in the non-DH group, 5.4±2.6 years (P = 0.588). In the DH group, 30 (50.8%) of 59 eyes manifested optic disc/RNFL deterioration; in the non-DH group, however, only 17 (28.8%) of 59 eyes showed structural progression. For the DH group, the cumulative probability of structural glaucoma progression was significantly greater than for the non-DH group (P = 0.001; log rank test). Interestingly, the two groups did not significantly differ in the cumulative probability of functional progression (P = 0.79; log rank test): in the DH group, VF progression was observed in 14 eyes (23.7%); in the non-DH group, in 12 eyes (20.3%).DH was associated with a greater probability of structural progression in medically well-controlled-IOP POAG eyes with mild-to-moderate myopia. However, the relevance of DH to VF progression was not clear over the course of the average 5.5-year duration of the study.

Dataset Information

African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Optic Disc Hemorrhage and Beta-Zone Parapapillary Atrophy.

Publications

African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Optic Disc Hemorrhage and Beta-Zone Parapapillary Atrophy.

Similar Datasets

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