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

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• 作者：Alon Skaat ; MD¹ ; ² ; Carlos Gustavo De Moraes ; MD ; MPH³ ; ^{gustavo.demoraes@columbia.edu" class="auth_mail" title="E-mail the corresponding author} ; Christopher Bowd ; PhD⁴ ; Pamela A. Sample ; PhD⁴ ; Christopher A. Girkin ; MD ; MSPH⁵ ; Felipe A. Medeiros ; MD ; PhD⁴ ; Robert Ritch ; MD¹ ; Robert N. Weinreb ; MD⁴ ; Linda M. Zangwill ; PhD⁴ ; Jeffrey M. Liebmann ; MD³ ; for the Diagnostic Innovations in Glaucoma Study ; African Descent ; Glaucoma Evaluation Study Groups
• 关键词：AD ; African descent ; ADAGES ; African Descent and Glaucoma Evaluation Study ; βPPA ; beta-zone parapapillary atrophy ; CCT ; central corneal thickness ; CI ; confidence interval ; dB ; decibels ; DH ; disc hemorrhage ; DIGS ; Diagnostic Innovations in Glaucoma Study ; ED ; European descent ; GON ; glaucomatous optic neuropathy ; IDEA ; Imaging Data Evaluation and Analysis ; MD ; mean deviation ; OCT ; optical coherence tomography ; OR ; odds ratio ; UCSD ; University of California-San Diego ; VF ; visual field
• 刊名：Ophthalmology
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：123
• 期：7
• 页码：1476-1483
• 全文大小：609 K

文摘

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).

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 βPPA. 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 βPPA 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 βPPA.

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 βPPA 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 βPPA 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 βPPA. 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 βPPA affect the likelihood of glaucomatous progression.