African Descent and Glaucoma Evaluation Study (ADAGES): Racial Differences in Optic Disc Hemorrhage and Beta-Zone Parapapillary Atrophy.
To investigate the differences in the frequency of optic disc hemorrhage (DH) and prevalence of beta-zone parapapillary atrophy (βPPA) between individuals of African descent (AD) and European descent (ED).



Prospective, multicenter, observational cohort.



A total of 1950 eyes of 1172 participants of the African Descent and Glaucoma Evaluation Study (ADAGES).



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 βPPA. 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 βPPA between the AD and ED groups. The analyses were then adjusted for clinical parameters using multivariable logistic regression.



Differences in frequency of DH and prevalence of βPPA.



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 βPPA 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 βPPA than ED eyes (OR, 1.55; 95% CI, 1.12-2.14; P = 0.008).



Subjects of ED are at higher risk for developing DH compared with AD subjects, whereas AD subjects have greater prevalence of βPPA. 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 βPPA affect the likelihood of glaucomatous progression.
New York Eye and Ear Infirmary, New York, New York; Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Alon
A
Skaat
Bernard and Shirlee Brown Glaucoma Research Laboratory, Harkness Eye Institute, Columbia University Medical Center, New York, New York. Electronic address: gustavo.demoraes@columbia.edu.
Carlos Gustavo
CG
De Moraes
Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, California.
Christopher
C
Bowd
Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, California.
Pamela A
PA
Sample
School of Medicine, University of Alabama, Birmingham, Alabama.
Christopher A
CA
Girkin
Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, California.
Felipe A
FA
Medeiros
New York Eye and Ear Infirmary, New York, New York.
Robert
R
Ritch
Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, California.
Robert N
RN
Weinreb
Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, California.
Linda M
LM
Zangwill
Bernard and Shirlee Brown Glaucoma Research Laboratory, Harkness Eye Institute, Columbia University Medical Center, New York, New York.
Jeffrey M
JM
Liebmann
D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D005901:Glaucoma / Q000208:ethnology / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009896:Optic Atrophy / Q000453:epidemiology* / Q000473:pathology; D009898:Optic Disk / Q000473:pathology*; D015995:Prevalence; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000453:epidemiology* / Q000473:pathology; D014481:United States / Q000453:epidemiology; D058609:Visual Field Tests; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American