Prevalence and Factors Associated with Optic Disc Tilt in the Primary Open-Angle African American Glaucoma Genetics Study

Daniel, Ebenezer; Addis, Victoria; Maguire, Maureen G.; McGeehan, Brendan; Chen, Min; Salowe, Rebecca; Zenebe-Gete, Selam; Meer, Elana; Lee, Roy; Smith, Elizabeth; Gudiseva, Harini V.; Sankar, Prithvi S.; O’Brien, Joan M.

doi:10.1016/j.ogla.2022.02.004

Cited by 5 publications

(9 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, a dose-response meta-analysis by Ha et al showed that the association is even stronger between moderate to high myopia and POAG, with a pooled OR of 4.14 (95% CI, 2.57-6.68). However, there are a few prior studies that have reported a null or even negative association between myopia and POAG, particularly in select racial and ethnic groups of small sample sizes . Nonetheless, the results of our present study are consistent with the existing literature suggesting evidence for a positive association between myopia and POAG.…”

Section: Discussionsupporting

confidence: 89%

Association Between Myopia and Primary Open-Angle Glaucoma by Race and Ethnicity in Older Adults in the California Medicare Population

Yao

Kitayama

et al. 2023

JAMA Ophthalmol

View full text Add to dashboard Cite

ImportanceRacial and ethnic differences in the association between myopia and primary open-angle glaucoma (POAG) are not well understood.ObjectiveTo investigate the association between myopia and POAG in the 2019 California Medicare population and to investigate whether there was evidence of effect measure modification of this association by race and ethnicity.Design, Setting, and ParticipantsThis cross-sectional study used administrative claims data from 2019 California Medicare beneficiaries 65 years or older with California residence and active coverage with Medicare parts A and B. Analysis took place between October 2021 and October 2023.ExposuresThe primary exposure was myopia, which was defined by International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes.Main Outcomes and MeasuresThe outcome of interest was POAG, which was defined by ICD-10-CM code.ResultsOf 2 717 346 California Medicare beneficiaries in 2019, 1 440 769 (53.0%) were aged 65 to 74 years, 1 544 479 (56.8%) identified as female, 60 211 (2.2%) had myopia, and 171 988 (6.3%) had POAG. Overall, 346 723 individuals (12.8%) identified as Asian, 117 856 (4.3%) as Black, 430 597 (15.8%) as Hispanic, 1 705 807 (62.8%) as White, and 115 363 (4.2%) as other race and ethnicity. In adjusted logistic regression analyses, beneficiaries with myopia had higher odds of POAG compared with beneficiaries without myopia (odds ratio [OR], 2.41; 95% CI, 2.35-2.47). In multivariable models stratified by race and ethnicity, the association between myopia and POAG was stronger in Asian (OR, 2.74; 95% CI, 2.57-2.92), Black (OR, 2.60; 95% CI, 2.31-2.94), and Hispanic (OR, 3.28; 95% CI, 3.08-3.48) beneficiaries compared with non-Hispanic White beneficiaries (OR, 2.14; 95% CI, 2.08-2.21).Conclusions and RelevanceIn the 2019 California Medicare population, myopia was associated with greater adjusted odds of POAG. This association was stronger among Asian, Black, and Hispanic beneficiaries compared with non-Hispanic White beneficiaries. These findings suggest possible disparities in glaucoma risk by race and ethnicity in individuals with myopia and may indicate greater need for glaucoma screening in individuals with myopia from racial and ethnic minority backgrounds.

show abstract

Section: Discussionsupporting

confidence: 89%

Association Between Myopia and Primary Open-Angle Glaucoma by Race and Ethnicity in Older Adults in the California Medicare Population

Yao

Kitayama

et al. 2023

JAMA Ophthalmol

View full text Add to dashboard Cite

show abstract

“…The authors contended that because GCs tended to occur frequently in eyes with large, non-tilted optic discs that had large horizontal diameters of the optic disc, they would not alter the results of the association of the ovality index and the bihemispheric RNFL defect 12. While this is likely true when ovality index is used as a measure of optic disc tilt, when stereoscopically identified tilt is used, it might alter the results, as has been shown in a previous report 13. This study was performed on Korean eyes where optic disc tilt has been associated with myopic glaucoma 14.…”

Section: Discussionmentioning

confidence: 91%

“…12 While this is likely true when ovality index is used as a measure of optic disc tilt, when stereoscopically Open access identified tilt is used, it might alter the results, as has been shown in a previous report. 13 This study was performed on Korean eyes where optic disc tilt has been associated with myopic glaucoma. 14 More investigation is required to understand the association of optic disc GC and stereoscopically identified tilt in an African ancestry population with glaucoma.…”

Section: Open Accessmentioning

confidence: 99%

Prevalence and factors associated with optic disc grey crescent in the Primary Open-Angle African Ancestry Glaucoma Genetics (POAAGG) Study

et al. 2023

Self Cite

View full text Add to dashboard Cite

AimTo investigate the prevalence and factors associated with optic disc grey crescent (GC) in African Americans with glaucoma.MethodsStereo optic disc image features from subjects with glaucoma in the Primary Open-Angle African Ancestry Glaucoma Genetics Study were evaluated independently by non-physician graders and discrepancies adjudicated by an ophthalmologist. Risk factors for GC were evaluated by logistic regression models with intereye correlation accounted for by generalised estimating equations. Adjusted ORs (aORs) were generated.ResultsGC was present in 227 (15%) of 1491 glaucoma cases, with 57 (3.82%) bilateral and 170 (11.4%) unilateral. In multivariable analysis, factors associated with GC were younger age (aOR 1.27, 95% CI 1.11 to 1.43 for every decade younger in age, p=0.001), diabetes (aOR 1.46, 95% CI 1.09 to 1.96, p=0.01), optic disc tilt (aOR 1.84, 95% CI 1.36 to 2.48, p<0.0001), a sloping retinal region adjacent to the outer disc margin (aOR 2.37, 95% CI 1.74 to 3.32, p<0.0001) and beta peripapillary atrophy (aOR 2.32, 95% CI 1.60 to 3.37, p<0.0001). Subjects with GC had a lower mean (SD) value of the ancestral component q0 than those without GC (0.22 (0.15) vs 0.27 (0.20), p=0.001), consistent with higher degrees of African ancestry.ConclusionsMore than 1 in 10 glaucoma cases with African ancestry have GC, occurring more frequently in younger subjects, higher degrees of African ancestry and diabetes. GC was associated with several ocular features, including optic disc tilt and beta peripapillary atrophy. These associations should be considered when evaluating black patients with primary open-angle glaucoma.

show abstract

“… 24 Two graders independently completed a standardised grading of each photo for numerous features of the optic cup and disc. 25 The Reading Center Director adjudicated any discrepancies between the two graders.…”

Section: Methodsmentioning

confidence: 99%

“…Three non-physician graders were trained by glaucoma specialists to grade these digital stereo colour images using a stereo viewer (Screen-Vu stereoscope, Portland, Oregon, USA), as detailed elsewhere 24. Two graders independently completed a standardised grading of each photo for numerous features of the optic cup and disc 25. The Reading Center Director adjudicated any discrepancies between the two graders.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for structural and functional progression of primary open-angle glaucoma in an African ancestry cohort

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background/aimsTo investigate the rates of structural and functional progression of primary open-angle glaucoma in an African ancestry cohort and identify risk factors for progression.MethodsThis 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.ResultsThe 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).ConclusionThe 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.

show abstract

Prevalence and Factors Associated with Optic Disc Tilt in the Primary Open-Angle African American Glaucoma Genetics Study

Cited by 5 publications

References 42 publications

Association Between Myopia and Primary Open-Angle Glaucoma by Race and Ethnicity in Older Adults in the California Medicare Population

Association Between Myopia and Primary Open-Angle Glaucoma by Race and Ethnicity in Older Adults in the California Medicare Population

Prevalence and factors associated with optic disc grey crescent in the Primary Open-Angle African Ancestry Glaucoma Genetics (POAAGG) Study

Risk factors for structural and functional progression of primary open-angle glaucoma in an African ancestry cohort

Contact Info

Product

Resources

About