From the Bernard and Shirlee Brown Glaucoma Research Laboratory (B.M., I.A.V., G.D.M., G.A.C., J.M.L.), Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York, USA; Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery (B.M., J.S.P.), Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
From the Bernard and Shirlee Brown Glaucoma Research Laboratory (B.M., I.A.V., G.D.M., G.A.C., J.M.L.), Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York, USA.
Am J Ophthalmol. 2022 Jul;239:122-129. doi: 10.1016/j.ajo.2022.02.003. Epub 2022 Feb 13.
To compare the rates of visual field (VF) progression between individuals of Black and White race and to investigate whether treatment effects may help explain differences previously reported between racial groups.
Multicenter prospective observational cohort study.
Participants were patients in referral tertiary care glaucoma clinics with open angle glaucoma. Eyes were excluded who had <5 VF tests and <2 years of follow-up or any disease that could affect the optic nerve or the VF. The VF mean deviation (MD) slopes over time (dB/y) were calculated with linear regression models. Socioeconomic variables, rates of glaucoma surgery, medications, treated intraocular pressure (IOP), and central corneal thickness (CCT) were investigated.
A total of 516 eyes were included with a mean (95% CI) follow-up time of 11.0 (range, 10.5-11.5) years and 15.0 (range, 14.1-15.8) visits. Participants of Black race were significantly younger (59.7 vs 66.9 years, P < .01) than those of White race. The mean CCT and socioeconomic variables were similar between Black and White groups (P = 0.20 and P = .56, respectively), as were treatment with topical medications (P = .90) and the rate of VF MD change (-0.24 [-0.31 to -0.17] dB/year vs -0.32 [-0.36 to -0.27], P = .11), despite higher treated mean IOP (14.9 [14.5 to 15.4] vs 14.0 [13.6 to 14.4] mm Hg, P = .03) and fewer trabeculectomies (29.5% vs 50.0%, P < .01) in the Black race group.
Rates of VF progression were similar despite higher treated IOP in the Black race group. Mitigation of health access disparities in this study may have equalized previously reported different rates of VF progression between racial groups.
比较黑人和白人种族个体之间视野（VF）进展的速度，并探讨治疗效果是否有助于解释先前报告的不同种族群体之间的差异。
多中心前瞻性观察队列研究。
参与者为具有开角型青光眼的转诊三级护理青光眼诊所的患者。排除具有<5 次 VF 测试和<2 年随访或任何可能影响视神经或 VF 的疾病的眼睛。使用线性回归模型计算随时间推移的 VF 平均偏差（MD）斜率（dB/y）。研究了社会经济变量、青光眼手术率、药物、治疗眼内压（IOP）和中央角膜厚度（CCT）。
共纳入 516 只眼，平均（95%CI）随访时间为 11.0 年（范围，10.5-11.5 年）和 15.0 次就诊（范围，14.1-15.8 年）。黑人种族的参与者明显比白人种族的参与者年轻（59.7 岁 vs 66.9 岁，P<.01）。黑人组和白人组的平均 CCT 和社会经济变量相似（P=.20 和 P=.56），局部药物治疗（P=.90）和 VF MD 变化率（-0.24 [-0.31 至 -0.17] dB/年 vs -0.32 [-0.36 至 -0.27]，P=.11）也相似，尽管黑人组的治疗平均 IOP 较高（14.9 [14.5 至 15.4] vs 14.0 [13.6 至 14.4] mm Hg，P=.03）和更少的小梁切除术（29.5% vs 50.0%，P<.01）。
尽管黑人组的治疗 IOP 较高，但 VF 进展的速度相似。在这项研究中，缓解健康获取方面的差异可能使先前报告的不同种族群体之间的 VF 进展率趋于一致。
