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

作者：Skaat Alon; De Moraes Carlos Gustavo^*; Bowd Christopher; Sample Pamela A; Girkin Christopher A; Medeiros Felipe A; Ritch Robert; Weinreb Robert N; Zangwill Linda M; Liebmann Jeffrey M

来源：Ophthalmology, 2016, 123(7): 1476-1483.

DOI：10.1016/j.ophtha.2016.03.025

Purpose: To investigate the differences in the frequency of optic disc hemorrhage (DH) and prevalence of beta-zone parapapillary atrophy (beta 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 bPPA. 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 bPPA 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 beta 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 beta 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 beta 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 beta 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 bPPA affect the likelihood of glaucomatous progression.

• 出版日期2016-7