Nelson-Ayifah Doreen, Mashige Khathutshelo P, Munsamy Alvin J
Department of Optometry, University of KwaZulu-Natal, Durban, South Africa.
Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Optom Vis Sci. 2025 Jul 1;102(7):436-451. doi: 10.1097/OPX.0000000000002268. Epub 2025 Jun 5.
This study identified retinal biomarkers for various stages of primary open-angle glaucoma (POAG) severity in a high-risk Ghanaian population. The findings of this study may guide eye-health professionals in determining the POAG risk for Ghanaians to allow for early detection and management as a strategy to reduce POAG-related visual impairment.
This study aimed to determine the most reliable POAG retinal biomarkers for different stages of disease severity in a Ghanaian population.
Optic coherence tomography (OCT) was conducted on 487 persons with POAG and 339 controls using Zeiss Cirrus HD-OCT. Peripapillary retinal nerve fiber layer (ppRNFL), macula ganglion cell complex, and optic nerve head measurements were extracted from the OCT test results. POAG participants were classified into three groups based on disease severity. Cohen's d effect size and adjusted odds ratios (aOR) were used to determine the POAG predicting ability of the retinal parameters.
Superior and inferior ppRNFL were POAG biomarkers across all stages of POAG severity; early POAG (superior ppRNFL: Cohen's d effect size = 1.50, aOR = 0.03 and inferior ppRNFL: Cohen's d effect size = 1.55, aOR = 0.04), moderate POAG (superior ppRNFL: Cohen's d effect size = 2.03, aOR = 0.02 and inferior ppRNFL: Cohen's d effect size = 1.93, aOR = 0.02), and advanced POAG (superior ppRNFL: Cohen's d effect size = 2.79, aOR = 0.01 and inferior ppRNFL: Cohen's d effect size = 2.79, aOR = 0.02). The inferior sector of the macula ganglion cell complex was a significant POAG biomarker at the early (Cohen's d effect size = 0.94, aOR = 0.08) and moderate (Cohen's d effect size = 1.48, aOR = 0.05) stages of the disease, while inferotemporal sector was the best biomarker for the advanced stage (Cohen's d effect size = 2.20, aOR = 0.01). Larger optic disc area measurements were highly associated with early POAG (Cohen's d effect size = 0.89, aOR = 3.52) and fairly associated with moderate (Cohen's d effect size = 0.66, aOR = 1.63) and advanced (Cohen's d effect size = 0.46, aOR = 1.45) POAG.
The identified parameters may aid eye-health professionals in determining POAG risk for Ghanaians to allow for early detection and management.
本研究在高危加纳人群中确定了原发性开角型青光眼（POAG）严重程度各阶段的视网膜生物标志物。本研究结果可指导眼科保健专业人员确定加纳人患POAG的风险，以便进行早期检测和管理，作为减少POAG相关视力损害的一种策略。
本研究旨在确定加纳人群中不同疾病严重程度阶段最可靠的POAG视网膜生物标志物。
使用蔡司Cirrus HD-OCT对487例POAG患者和339名对照者进行光学相干断层扫描（OCT）。从OCT测试结果中提取视乳头周围视网膜神经纤维层（ppRNFL）、黄斑神经节细胞复合体和视神经乳头测量值。POAG参与者根据疾病严重程度分为三组。采用Cohen's d效应量和调整后的优势比（aOR）来确定视网膜参数对POAG的预测能力。
上、下ppRNFL是POAG严重程度各阶段的POAG生物标志物；早期POAG（上ppRNFL：Cohen's d效应量=1.50，aOR=0.03；下ppRNFL：Cohen's d效应量=1.55，aOR=0.04），中度POAG（上ppRNFL：Cohen's d效应量=2.03，aOR=0.02；下ppRNFL：Cohen's d效应量=1.93，aOR=0.02），晚期POAG（上ppRNFL：Cohen's d效应量=2.79，aOR=0.01；下ppRNFL：Cohen's d效应量=2.79，aOR=0.02）。黄斑神经节细胞复合体的下象限在疾病的早期（Cohen's d效应量=0.94，aOR=0.08）和中度（Cohen's d效应量=1.48，aOR=0.05）阶段是显著的POAG生物标志物，而颞下象限是晚期阶段的最佳生物标志物（Cohen's d效应量=2.20，aOR=0.01）。较大的视盘面积测量值与早期POAG高度相关（Cohen's d效应量=0.89，aOR=3.52），与中度（Cohen's d效应量=0.66，aOR=1.63）和晚期（Cohen's d效应量=0.46，aOR=1.45）POAG有一定相关性。
所确定的参数可能有助于眼科保健专业人员确定加纳人患POAG的风险，以便进行早期检测和管理。
