Racial differences in optic disc topography: baseline results from the confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study.
OBJECTIVE
To examine racial differences in optic disc topography among ocular hypertensive participants in the Ocular Hypertension Treatment Study.


METHODS
Four hundred thirty-nine participants from 7 Ocular Hypertension Treatment Study centers who had good-quality baseline images obtained using a quantitative 3-dimensional confocal scanning laser ophthalmoscope, the Heidelberg Retina Tomograph (Heidelberg Engineering, Dossenheim, Germany), were included in this study. The first 10 degrees- or 15 degrees-field of view mean topographic image acquired was included in all analyses. Differences in Heidelberg Retina Tomograph topographic optic disc parameter measurements by self-identified race were assessed using a mixed-effects linear model to control for confounders and for the use of both eyes in the model.


RESULTS
By self-attribution, 74 (17%) of the 439 participants were of African origin, 329 (75%) were white, 24 (5%) were Hispanic, and 12 (3%) were Native American, Native Alaskan, Asian, Pacific Islander, or unknown. The African American participants had statistically significantly (P<.001) larger mean (SD) optic disc areas than the other participants, 2.17 (0.41) mm(2) vs 1.87 (0.38) mm(2), respectively. African American participants had a larger cup area, cup volume, cup depth, neuroretinal rim area, rim volume, and smaller rim-optic disc area ratios than the other participants. No difference between African American and the other participants was found for cup shape and retinal nerve fiber layer thickness. After controlling for optic disc area, none of the differences between African American and the other participants found in the univariate analysis remained statistically significant (P>.10).


CONCLUSIONS
This study demonstrated in a large cohort of subjects with ocular hypertension, that African Americans have significantly larger optic discs, optic cups, neuroretinal rims, and cup-disc ratios than other racial groups. Furthermore, this study found that differences in topographic optic disc parameters between African Americans with ocular hypertension and other racial groups are largely explained by the larger optic disc area in the African Americans. These results highlight the need to consider race and optic disc size when evaluating the appearance of the optic disc in glaucoma.
Zangwill
Linda M
LM
Department of Ophthalmology, University of California, San Diego, La Jolla 92093, USA. zangwill@eyecenter.ucsd.edu
Weinreb
Robert N
RN
Berry
Charles C
CC
Smith
Amanda R
AR
Dirkes
Keri A
KA
Coleman
Anne L
AL
Piltz-Seymour
Jody R
JR
Liebmann
Jeffrey M
JM
Cioffi
George A
GA
Trick
Gary
G
Brandt
James D
JD
Gordon
Mae O
MO
Kass
Michael A
MA
D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D005902:Glaucoma, Open-Angle / Q000517:prevention & control; D006801:Humans; D007429:Intraocular Pressure; D007834:Lasers; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000208:ethnology*; D009887:Ophthalmoscopy / Q000379:methods*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000208:ethnology* / Q000517:prevention & control; D044469:Racial Groups; D014794:Visual Fields
D000959:Antihypertensive Agents