African Descent and Glaucoma Evaluation Study (ADAGES) (original) (raw)
Related papers
Racial Differences in the Association between Optic Disc Topography and Early Glaucoma
Investigative Ophthalmology & Visual Science, 2003
PURPOSE. To determine the structural characteristics of the optic disc that are associated with early glaucoma in African Americans and whites and whether these characteristics differ between the races. METHODS. Parameters of optic disc topography from 260 African American eyes and 193 white eyes were included in the analysis. One hundred forty-four eyes of African Americans and 109 eyes of normal white subjects were used as a control group. Logistic regression was used to calculate the association between early glaucoma, defined by the visual field, and cup, rim, and disc margin confocal scanning laser ophthalmoscopic (CSLO) parameters, using odds ratios at binary cut points. The cup, rim, and disc margin parameters identified as being independently associated with glaucoma in these reduced models were then included in a single multivariate model. Optic disc area was included in the analysis at each level of the model. This approach was used for the total study group and then separately for the African American and white groups. RESULTS. When accounting for difference in optic disc area, rim area had the highest independent association with early glaucoma in both groups, but this association was lower in African Americans (odds ratio [95% confidence interval]: 1.63 [1.12-2.36]) than in whites (odds ratio: 4.74 [2.18-10.28]). Additional independently associated parameters included cup shape, maximum elevation along the contour line, and the temporal-to-inferior contour line modulation ratio in whites and cup shape and the temporal-to-superior contour line modulation ratio in African Americans. CONCLUSIONS. Structural characteristics of the optic disc that are best associated with early glaucoma included cup shape and rim area in both groups, but with a less pronounced association in African Americans. In addition, several other racespecific parameters that were independently associated with early glaucoma differed significantly between African Americans and whites. These race-specific differences were independent from the effect of optic disc area.
Journal of Ophthalmology
Purpose. To determine normative values of retinal nerve fibre layer thickness (RNFL) and optic nerve head (ONH) parameters and their association with routine clinical tests such as refractive error (RE), stereoacuity (SA), and contrast sensitivity (CS) in an African population. Methods. In a cross-sectional observational study, 100 normal subjects aged 20 to 78 years were evaluated using the Cirrus HD-OCT 5000 and matched with 200 glaucoma patients. Results. Average (±SD) RNFL thickness for normal subjects was found to be 102.37 ± 7.45 (range, 82–119 microns) compared with 90.74 ± 14.50 found for glaucoma subjects. Females had higher average RNFL values (104.84 ± 6.90) compared with males (99.80 ± 7.18). Significant associations were calculated between quadrant RNFL thickness and SA, SE, and CS (all p<0.05). The mean cup to disc ratio (CDR) was 0.49 ± 0.12, and mean optic disc area (DA) was 2.08 mm2 ± 0.40. Smaller DA was recorded for participants aged 60+ years (1.86 ± 0.25), fo...
Subjective and Objective Optic Nerve Assessment in African Americans and Whites
Investigative Ophthalmology & Visual Science, 2004
OBJECTIVE. To compare the ability of quantitative optic disc topography and subjective optic disc evaluation to discriminate early glaucomatous from normal eyes in African Americans and whites. METHODS. Monocular data from eyes of 88 African-American patients and 63 eyes of white patients with glaucoma were included in the analysis. Sixty-three eyes of African American normal subjects and 42 eyes of white normal subjects were used as a control group. Racial groups were defined by selfdescription. All subjects underwent topographic imaging, stereophotography, and standard perimetry. Glaucoma was defined by visual field defect alone. Stereophotos were graded in a masked fashion by three independent graders. The areas under the receiver operator curve (aROCs) were calculated for the overall stereophoto grade, each confocal scanning laser ophthalmoscope (CSLO) parameter, and previously described discriminant functions. After adjustment for disc area and age, the aROC associated with each parameter, discriminant function, and subjective stereophoto grade were compared between African Americans and whites. RESULTS. The aROC for masked stereophotographic disc evaluation and the best discriminatory CSLO parameter (cup-to-disc ratio, CDR) was similar in whites (0.869 stereophotographic, 0.858 CSLO CDR) and African Americans (0.865 stereophotographic, 0.850 CSLO CDR). No significant differences were found between the aROC with subjective stereophotographic assessment and the most discriminatory optic disc parameter in either racial group. CONCLUSIONS. Previously described racial differences in optic disc structure have little impact on the relative ability of subjective or objective methods to discriminate between glaucomatous and nonglaucomatous optic discs; however, differences in normative values necessitate race-specific cutoffs, to optimize disease detection strategies.
Racial Differences in Optic Disc Topography
Archives of Ophthalmology, 2004
Objective: To examine racial differences in optic disc topography among ocular hypertensive participants in the Ocular Hypertension Treatment Study.
Investigative ophthalmology & visual science, 2015
We determined if quantitative measurements of biogeographic ancestry (BGA) correlate with variations in optic disc area, corneal thickness (CCT), and retinal nerve fiber layer (RNFL) thickness. Data were obtained from 656 participants in the African Descent and Glaucoma Evaluation Study (ADAGES) cohort who consented to BGA testing. Data for CCT, optic disc area, and RNFL thickness were obtained from subjects in the ADAGES study who also had participated in the current substudy. A total of 31 ancestry informative markers (AIMs) with large allele frequencies differences between populations was used to calculate admixture proportion (implemented in STRUCTURE). Correlations with BGA adjusted for diagnosis, age, and sex for CCT and optic disc area using the whole group and RNFL thickness adjusted for age and sex for the normal study participants were determined. The mean percentage of African admixture was 79.6% in the self-described African Descent (AD) group and 3.5% in the European De...
The African Descent and Glaucoma Evaluation Study (ADAGES) III
Ophthalmology, 2019
Purpose-To describe the study protocol and baseline characteristics of the "African Descent and Glaucoma Evaluation Study (ADAGES) III: Contribution of Genotype to Glaucoma phenotype in African Americans". Design-Cross-sectional, case-control study Participants-There were 3266 glaucoma patients and controls without glaucoma of African or European descent recruited from five study centers in different regions of the United States. Methods-Individuals of African descent (AD) and European descent (ED) with primary open angle glaucoma (POAG) and control subjects completed a detailed demographic and medical history interview. Standardized height, weight and blood pressure measurements were obtained. Saliva and blood samples to provide serum, plasma, DNA and RNA were collected for standardized processing. Visual fields, stereoscopic disc photographs, and details of the ophthalmic examination were obtained and transferred to the University of California-San Diego Data Coordinating Center for standardized processing and quality review. Main Outcome Measures-Participant gender, age, race, body mass index, blood pressure, history of smoking and alcohol use in POAG patients and controls are described. Ophthalmic measures included intraocular pressure, visual field mean deviation, central corneal thickness, glaucoma medication use or past glaucoma surgery. Ocular conditions including diabetic retinopathy, age-related macular degeneration and past cataract surgery were recorded. Results-The 3266 ADAGES III study participants in this report include 2146 AD POAG patients, 695 ED POAG patients, 198 AD controls and 227 ED controls. AD POAG patients and controls were significantly younger (both 67.4 years) than ED POAG patients and controls (73.4 and 70.2 years, respectively). After adjusting for age, AD POAG patients had different phenotypic characteristics compared to ED POAG patients, including higher intraocular pressure, worse visual acuity and visual field mean deviation, and thinner corneas (all p<0.001). Family history of glaucoma did not differ between AD and ED POAG patients. Conclusions-With its large sample size, extensive specimen collection and deep phenotyping of AD and ED glaucoma patients and controls from different regions in the United States, the ADAGES III Genomics Study will address gaps in our knowledge of the genetics of POAG in this high-risk population. Glaucoma is the leading cause of irreversible blindness in individuals of African Descent (AD), and the second leading cause of irreversible blindness in all Americans 1-3. As the population ages, the number of persons with primary open angle glaucoma (POAG) in the United States will increase by approximately 50% to over 3.3 million in 2020 4. Individuals of AD are more likely to become blind 5-7 , and are fifteen times more likely to develop POAG-associated visual impairment 8 than individuals of European Descent (ED).
British Journal of Ophthalmology, 2009
Aim To examine ethnic differences in optic nerve head and retinal nerve fibre layer (RNFL) parameters between European Caucasian and East Asian children aged 6e12 years. Methods Of 4118 children examined in the Sydney Childhood Eye Study (incorporating the Sydney Myopia Study) from 34 randomly selected primary and 21 secondary schools during 2003e5, 3382 (82.1%) had optical coherence tomography (OCT; Zeiss Stratus) data suitable for analysis. 'Fast' optic disc and RNFL scans were used. Ethnicity was defined only when both parents were of the same ethnicity. Results East Asian children tended to have a lower birth weight, were shorter with a smaller body mass index and were less hyperopic than European Caucasian children of the same age. After adjusting for age, gender, axial length, birth weight and optic-disc area, East Asian children had similar mean vertical disc diameters to European Caucasians (p¼0.38, p¼0.64 for 6e12 years, respectively) but 30e43% larger mean vertical cup diameters (p<0.0001 for both), resulting in larger mean cup/disc ratios (p<0.0001 for both). Compared with European Caucasians (101.95 mm and 104.57 mm, respectively), East Asian children had thicker mean average RNFL (105.45 mm and 107.92 mm, respectively; p¼0.0006 and 0.0001) and thicker non-nasal RNFL quadrants in both ages. Conclusions Compared with European Caucasian children, East Asian children generally had thicker RNFL and larger mean cup/disc ratios. Given the relatively lower prevalence of open angle glaucoma in Asians, these anatomical variations could contribute to better understanding of apparent racial differences in glaucoma susceptibility.
2014
Early detection of glaucoma relies on a detailed knowledge of how the normal optic nerve (ONH) varies within the population. The purpose of this study focused on two main areas; 1. To explore the optic nerve head appearance in the normal optometric population and compare the south Asian (principally Pakistani) with the European white population, correcting for possible ocular and non-ocular influences in a multiple regression model. The main findings were: • The optic discs of the South Asian (SA) and White European (WE) populations were not statistically different in size. The SA group possessed discs with increased cupping and thinner neuro-retinal rims (NRR) compared with the WE group. The SA group also demonstrated a more vertically oval shape than the WE population. These differences were significant at the p<0.01 level. • The upper limits of inter-eye asymmetry were: ≤0.2 for cup to disc area ratio, and 3mmHg for intra-ocular pressure (IOP) for both ethnic groups and this d...