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Abstract #98849 Published in IGR 22-4
Glaucomatous Visual Field Progression in the African Descent and Glaucoma Evaluation Study (ADAGES): Eleven Years of Follow-up
Melchior B; Valenzuela IA; De Moraes CG; Paula JS; Fazio MA; Girkin CA; Proudfoot J; Proudfoot J; Cioffi GA; Weinreb RN; Zangwill LM; Liebmann JMAmerican Journal of Ophthalmology 2022; 239: 122-129
PURPOSE: To compare the rates of visual field (VF) progression between individuals of Black and White race and to investigate whether treatment effects may help explain differences previously reported between racial groups. DESIGN: Multicenter prospective observational cohort study. METHODS: Participants with open angle glaucoma excluding those that had < 5 VF tests and < 2 years of follow-up, or any disease that could affect the optic nerve or the VF. The VF mean deviation (MD) slopes over time (dB/year) were calculated with linear regression models. We investigated socioeconomic (SE) variables, rates of glaucoma surgery, medications, treated intraocular pressure (IOP), and central corneal thickness (CCT). SETTING: Tertiary care glaucoma clinics. RESULTS: A total of 516 eyes were included with a mean (95% CI) follow-up time of 11.0 (10.5 to 11.5) years and 15.0 (14.1 to 15.8) visits. Participants of Black race were significantly younger (59.7 vs 66.9 years old, P < 0.01). The mean CCT and SE variables were similar between Black and White groups (P = 0.21 and P = 0.56, respectively), as were treatment with topical medications (P = 0.90) and the rate of VF MD change (-0.24 [-0.31 to -0.17] dB/year vs -0.32 [-0.36 to -0.27], P= 0.11), despite higher treated mean IOP (14.9 [14.5 to 15.4] vs 14.0 [13.6 to 14.4] mmHg, P=0.03) and fewer trabeculectomies (29.5% vs 50.0%, p < 0.01) in the Black race group. CONCLUSIONS: Rates of VF progression were similar despite higher treated IOP in the Black race group. Mitigation of health access disparities in this study may have equalized previously reported different rates of VF progression between racial groups.
Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY; Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
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