Zangwill Linda M, Weinreb Robert N, Berry Charles C, Smith Amanda R, Dirkes Keri A, Coleman Anne L, Piltz-Seymour Jody R, Liebmann Jeffrey M, Cioffi George A, Trick Gary, Brandt James D, Gordon Mae O, Kass Michael A
Department of Ophthalmology, University of California, San Diego, La Jolla 92093, USA.
Arch Ophthalmol. 2004 Jan;122(1):22-8. doi: 10.1001/archopht.122.1.22.
To examine racial differences in optic disc topography among ocular hypertensive participants in the Ocular Hypertension Treatment Study.
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.
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).
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.
在眼压升高治疗研究中，研究眼压升高参与者视盘地形图的种族差异。
本研究纳入了来自7个眼压升高治疗研究中心的439名参与者，他们使用定量三维共焦扫描激光眼底镜（德国海德堡工程公司的海德堡视网膜断层扫描仪）获得了高质量的基线图像。所有分析均纳入首次获取的10度或15度视野平均地形图。使用混合效应线性模型评估自我认定种族在海德堡视网膜断层扫描仪视盘地形图参数测量上的差异，以控制混杂因素并在模型中纳入双眼情况。
根据自我认定，439名参与者中74名（17%）为非洲裔，329名（75%）为白人，24名（5%）为西班牙裔，12名（3%）为美洲原住民、阿拉斯加原住民、亚洲人、太平洋岛民或种族不明。非裔美国参与者的平均（标准差）视盘面积在统计学上显著大于其他参与者（P<0.001），分别为2.17（0.41）mm²和1.87（0.38）mm²。非裔美国参与者的杯盘面积、杯盘体积、杯盘深度、神经视网膜边缘面积、边缘体积更大，杯盘面积比更小。非裔美国参与者与其他参与者在杯盘形状和视网膜神经纤维层厚度方面未发现差异。在控制视盘面积后，单因素分析中发现的非裔美国参与者与其他参与者之间的差异均无统计学意义（P>0.10）。
本研究在一大群眼压升高的受试者中表明，非裔美国人的视盘、视杯、神经视网膜边缘和杯盘比显著大于其他种族群体。此外还发现，眼压升高的非裔美国人与其他种族群体在视盘地形图参数上的差异很大程度上是由非裔美国人较大的视盘面积所解释。这些结果凸显了在评估青光眼视盘外观时考虑种族和视盘大小的必要性。
