PT  - JOURNAL ARTICLE
AU  - Brian Stagg
AU  - Eduardo B Mariottoni
AU  - Samuel Berchuck
AU  - Alessandro Jammal
AU  - Angela R Elam
AU  - Rachel Hess
AU  - Kensaku Kawamoto
AU  - Benjamin Haaland
AU  - Felipe A Medeiros
TI  - Longitudinal visual field variability and the ability to detect glaucoma progression in black and white individuals
AID  - 10.1136/bjophthalmol-2020-318104
DP  - 2022 Aug 01
TA  - British Journal of Ophthalmology
PG  - 1115--1120
VI  - 106
IP  - 8
4099  - http://bjo.bmj.com/content/106/8/1115.short
4100  - http://bjo.bmj.com/content/106/8/1115.full
SO  - Br J Ophthalmol2022 Aug 01; 106
AB  - Background/Aims To investigate racial differences in the variability of longitudinal visual field testing in a ‘real-world’ clinical population, evaluate how these differences are influenced by socioeconomic status, and estimate the impact of differences in variability on the time to detect visual field progression.Methods This retrospective observational cohort study used data from 1103 eyes from 751 White individuals and 428 eyes from 317 black individuals. Linear regression was performed on the standard automated perimetry mean deviation values for each eye over time. The SD of the residuals from the trend lines was calculated and used as a measure of variability for each eye. The association of race with the SD of the residuals was evaluated using a multivariable generalised estimating equation model with an interaction between race and zip code income. Computer simulations were used to estimate the time to detect visual field progression in the two racial groups.Results Black patients had larger visual field variability over time compared with white patients, even when adjusting for zip code level socioeconomic variables (SD of residuals for Black patients=1.53 dB (95% CI 1.43 to 1.64); for white patients=1.26 dB (95% CI 1.14 to 1.22); mean difference: 0.28 (95% CI 0.15 to 0.41); p<0.001). The difference in visual field variability between black and white patients was greater at lower levels of income and led to a delay in detection of glaucoma progression.Conclusion Black patients had larger visual field variability compared with white patients. This relationship was strongly influenced by socioeconomic status and may partially explain racial disparities in glaucoma outcomes.Data are available on reasonable request. The Duke Glaucoma Registry data are maintained on HIPAA-compliant servers at Duke University.