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dc.contributor.authorGracitelli, Carolina Pelegrini Barbosa [UNIFESP]
dc.contributor.authorZangwill, Linda M.
dc.contributor.authorDiniz-Filho, Alberto
dc.contributor.authorAbe, Ricardo Y.
dc.contributor.authorGirkin, Christopher A.
dc.contributor.authorWeinreb, Robert N.
dc.contributor.authorLiebmann, Jeffrey M.
dc.contributor.authorMedeiros, Felipe Andrade [UNIFESP]
dc.identifier.citationJama Ophthalmology. Chicago, v. 136, n. 4, p. 329-335, 2018.
dc.description.abstractIMPORTANCE Individuals of African descent have been reported to be at higher risk for becoming visually impaired from glaucoma compared with individuals of European descent. OBJECTIVE To investigate racial differences in longitudinal visual field variability and their impact on time to detect visual field progression. DESIGN, SETTING, AND PARTICIPANTS This multicenter prospective observational cohort study included 236 eyes of 173 individuals of European descent and 235 eyes of 171 individuals of African descent followed up for a mean (SD) time of 7.5 (3.4) years. MAIN OUTCOMES AND MEASURES Differences in test-retest variability and simulated time to detect progression in individuals of African descent and of European descent with glaucoma. Standard automated perimetry mean deviation values were regressed over time for each eye, and SD of the residuals was used as a measure of variability. Distributions of residuals were used in computer simulations to reconstruct "real-world" standard automated perimetry mean deviation trajectories under different assumptions about rate of change and frequency of testing. Times to detect progression were obtained for the simulated visual fields. RESULTS Among the 344 patients, the mean (SD) age at baseline was 60.2 (10.0) and 60.6 (9.0) years for individuals of African descent and of European descent, respectivelyen
dc.description.abstract94 (52%) and 86 (48%) of individuals of African descent and of European descent were women, respectively. The mean SD of the residuals was larger in eyes of individuals of African descent vs those of European descent (1.45 [0.83] dB vs 1.12 [0.48] dBen
dc.description.abstractmean difference: 0.33 dBen
dc.description.abstract95% CI of the difference, 0.21-0.46en
dc.description.abstractP < .001). The eyes in individuals of African descent had a larger increase in variability with worsening disease (P < .001). When simulations were performed assuming common progression scenarios, there was a delay to detect progression in eyes of individuals of African descent compared with those of European descent. For a scenario with baseline mean deviation of -10 dB and rate of change of -0.5 dB/y, detection of progression in individuals of African descent was delayed by 3.1 (95% CI, 2.9-3.2) years, when considered 80% power and annual tests. CONCLUSIONS AND RELEVANCE Patients of African descent with glaucoma showed increased visual field variability compared with those of European descent, resulting in delayed detection of progression that may contribute to explain higher rates of glaucoma-related visual impairment in individuals of African descent compared with those of European descent with glaucoma.en
dc.description.sponsorshipNational Institutes of Health and National Eye Institute
dc.description.sponsorshipBrazilian National Council for Scientific and Technological Development
dc.description.sponsorshipBrazilian National Research Council-CAPES
dc.publisherAmer Medical Assoc
dc.relation.ispartofJama Ophthalmology
dc.rightsAcesso restrito
dc.titleDetection of Glaucoma Progression in Individuals of African Descent Compared With Those of European Descenten
dc.description.affiliationUniv Calif San Diego, Shiley Eye Inst, Dept Ophthalmol, La Jolla, CA 92093 USA
dc.description.affiliationUniv Fed Sao Paulo, Dept Ophthalmol, Sao Paulo, Brazil
dc.description.affiliationUniv Alabama Birmingham, Sch Med, Birmingham, AL USA
dc.description.affiliationColumbia Univ, Med Ctr, Edward S Harkness Eye Inst, New York, NY USA
dc.description.affiliationDuke Univ, Duke Eye Ctr, Dept Ophthalmol, 2351 Erwin Rd, Durham, NC 92093 USA
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Ophthalmol, Sao Paulo, Brazil
dc.description.sponsorshipIDNIH e NEI: EY021818
dc.description.sponsorshipIDNIH e NEI: EY025056
dc.description.sponsorshipIDNIH e NEI: EY011008
dc.description.sponsorshipIDNIH e NEI: EY14267
dc.description.sponsorshipIDNIH e NEI: EY019869
dc.description.sponsorshipIDNIH e NEI: P30EY022589
dc.description.sponsorshipIDCNPq: 233829/2014-8
dc.description.sponsorshipIDCAPES: 12309-13-3
dc.description.sourceWeb of Science
dc.citation.volumev. 136
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