title: The African Descent and Glaucoma Evaluation Study (ADAGES): predictors of visual field damage in glaucoma suspects.
abstract: OBJECTIVE
  To evaluate racial differences in the development of visual field (VF) damage in glaucoma suspects.
  
  
  METHODS
  Prospective, observational cohort study.
  
  
  METHODS
  Six hundred thirty-six eyes from 357 glaucoma suspects with normal VF at baseline were included from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES). Racial differences in the development of VF damage were examined using multivariable Cox proportional hazard models.
  
  
  RESULTS
  Thirty one of 122 African-descent participants (25.4%) and 47 of 235 European-descent participants (20.0%) developed VF damage (P = .078). In multivariable analysis, worse baseline VF mean deviation, higher mean arterial pressure during follow-up, and a race ∗ mean intraocular pressure (IOP) interaction term were significantly associated with the development of VF damage, suggesting that racial differences in the risk of VF damage varied by IOP. At higher mean IOP levels, race was predictive of the development of VF damage even after adjusting for potentially confounding factors. At mean IOPs during follow-up of 22, 24, and 26 mm Hg, multivariable hazard ratios (95% confidence intervals) for the development of VF damage in African-descent compared to European-descent subjects were 2.03 (1.15-3.57), 2.71 (1.39-5.29), and 3.61 (1.61-8.08), respectively. However, at lower mean IOP levels (below 22 mm Hg) during follow-up, African descent was not predictive of the development of VF damage.
  
  
  CONCLUSIONS
  In this cohort of glaucoma suspects with similar access to treatment, multivariate analysis revealed that at higher mean IOP during follow-up, individuals of African descent were more likely to develop VF damage than individuals of European descent.
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Naira
authors.initials: N
authors.lastname: Khachatryan
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Lucie
authors.initials: L
authors.lastname: Sharpsten
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bowd
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Sample
authors.affiliation: Harkness Eye Institute, Columbia University Medical Center, New York, New York.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Liebmann
authors.affiliation: Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Girkin
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
authors.affiliation: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Miki
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Na'ama
authors.initials: N
authors.lastname: Hammel
authors.affiliation: Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California. Electronic address: lzangwill@ucsd.edu.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Zangwill
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000208:ethnology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis / Q000208:ethnology*; D009898:Optic Disk / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000208:ethnology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis / Q000208:ethnology*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields; D044465:White People / Q000208:ethnology*