RT Journal Article
SR Electronic
T1 Longitudinal visual field variability and the ability to detect glaucoma progression in black and white individuals
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1115
OP 1120
DO 10.1136/bjophthalmol-2020-318104
VO 106
IS 8
A1 Brian Stagg
A1 Eduardo B Mariottoni
A1 Samuel Berchuck
A1 Alessandro Jammal
A1 Angela R Elam
A1 Rachel Hess
A1 Kensaku Kawamoto
A1 Benjamin Haaland
A1 Felipe A Medeiros
YR 2022
UL http://bjo.bmj.com/content/106/8/1115.abstract
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.