RT Journal Article
SR Electronic
T1 Risk factors for structural and functional progression of primary open-angle glaucoma in an African ancestry cohort
JF BMJ Open Ophthalmology
JO BMJ Open Ophth
FD BMJ Publishing Group Ltd
SP e001120
DO 10.1136/bmjophth-2022-001120
VO 8
IS 1
A1 Rebecca J Salowe
A1 Yineng Chen
A1 Selam Zenebe-Gete
A1 Roy Lee
A1 Harini V Gudiseva
A1 Isabel Di Rosa
A1 Ahmara G Ross
A1 Qi N Cui
A1 Eydie Miller-Ellis
A1 Victoria Addis
A1 Prithvi S Sankar
A1 Ebenezer Daniel
A1 Gui-shuang Ying
A1 Joan M O'Brien
YR 2023
UL http://bmjophth.bmj.com/content/8/1/e001120.abstract
AB Background/aims To investigate the rates of structural and functional progression of primary open-angle glaucoma in an African ancestry cohort and identify risk factors for progression.Methods This retrospective study included 1424 eyes from glaucoma cases in the Primary Open-Angle African American Glaucoma Genetics cohort, with ≥2 visits for retinal nerve fibre layer (RNFL) thickness and mean deviation (MD) measurements over ≥6-month follow-up. The rates of structural progression (change in RNFL thickness/year) and functional progression (change in MD/year) were calculated from linear mixed effects models, accounting for intereye correlation and longitudinal correlation. Eyes were categorised as slow, moderate or fast progressors. Risk factors for progression rates were assessed using univariable and multivariable regression models.Results The median (interquartile) rates of progression were −1.60 (−2.05 to –1.15) µm/year for RNFL thickness and −0.40 (−0.44 to –0.34) decibels/year for MD. Eyes were categorised as slow (structural: 19%, functional: 88%), moderate (structural: 54%, functional: 11%) and fast (structural: 27%, functional: 1%) progressors. In multivariable analysis, faster RNFL progression was independently associated with thicker baseline RNFL (p<0.0001), lower baseline MD (p=0.003) and beta peripapillary atrophy (p=0.03). Faster MD progression was independently associated with higher baseline MD (p<0.0001), larger cup-to-disc ratios (p=0.02) and lower body mass index (p=0.0004).Conclusion The median rates of structural and functional progression in this African ancestry cohort were faster than the rates reported from previously published studies in other ethnic groups. Higher baseline RNFL thickness and MD values were associated with faster progression rates. Results highlight the importance of monitoring structural and functional glaucoma progression to provide timely treatment in early disease.Data are available upon reasonable request. Detailed phenotypic data from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) cohort, including the progression data included in this paper, is accessible to interested parties by contacting the corresponding author. All POAAGG genotype files are available from the dbGap database (accession number phs001312.v1.p1; URL: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001312.v1.p1).