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. 2018 Dec:196:154-164.
doi: 10.1016/j.ajo.2018.08.050. Epub 2018 Sep 7.

Racial Differences in Rate of Change of Spectral-Domain Optical Coherence Tomography-Measured Minimum Rim Width and Retinal Nerve Fiber Layer Thickness

Christopher Bowd  1 , Linda M Zangwill  2 , Robert N Weinreb  1 , Christopher A Girkin  3 , Massimo A Fazio  3 , Jeffrey M Liebmann  4 , Akram Belghith  1
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Racial Differences in Rate of Change of Spectral-Domain Optical Coherence Tomography-Measured Minimum Rim Width and Retinal Nerve Fiber Layer Thickness

Christopher Bowd et al. Am J Ophthalmol. 2018 Dec.

Abstract

Purpose: To compare race-related differences in estimated rate of change of Bruch's membrane opening-minimum rim width (BMO-MRW) and circumpapillary retinal nerve fiber layer thickness (RNFLT) in healthy, glaucoma suspect, and glaucoma eyes of individuals of European (ED) and African descent (AD).

Design: Prospective cohort study.

Methods: This study investigated rate of change of BMO-MRW and RNFLT in 124 healthy, 227 glaucoma suspect, and 177 glaucoma eyes followed for approximately 3 years and tested with optical coherence tomography every 6 months. Suspect eyes had a history of untreated intraocular pressure (IOP) ≥ 22 mm Hg or suspicion of glaucoma by optic disc photograph assessment without repeatable abnormal standard automated perimetry (SAP) results. Glaucoma eyes had repeatable abnormal SAP results (GHT ONL or PSD ≤ 5%). Mixed-effects models were used to estimate the rate of change after controlling for age, mean follow-up IOP, central corneal thickness, axial length, and BMO area.

Results: A race-related difference in rate of change of global BMO-MRW but not average RNFLT in suspect eyes was observed. Rate of change of BMO-MRW was -1.82 μm/year and -2.20 μm/year in ED and AD suspect eyes, respectively (P = .03). Rate of change of RNFLT was -0.64 μm/year and -0.75 μm/year in ED and AD suspect eyes, respectively (P = .75). No race-related differences in change rate were found in healthy or glaucoma eyes.

Conclusion: Race is an important consideration when assessing structural change, particularly minimum rim width, in glaucoma suspect eyes. Differences in rate of structural change may help explain racial disparities in glaucoma susceptibility.

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Figures

Figure 1.
Figure 1.
Example of San Diego Automated Layer Segmentation Algorithm identified Bruch’s membrane opening minimum rim width (BMO-MRW) defined on a single Spectralis b-scan as the minimum distance between the BMO and internal limiting membrane (ILM).
Figure 2.
Figure 2.
Distributions of the global Bruch’s membrane minimum rim width (BMO-MRW) estimated rates of change over time (μm/year) for African descent (AD) and European descent (ED) eyes in healthy (left), glaucoma suspect (center) and glaucoma (right) eyes. Change in MRW is significant between AD and ED eyes in suspect eyes only.
Figure 3.
Figure 3.
Pie charts showing Bruch’s membrane minimum rim width (BMO-MRW) estimated rates of change over time (μm/year) by sector for African descent (AD) and European descent (ED) eyes in healthy (left), glaucoma suspect (center) and glaucoma (right) eyes. Change in MRW is significant between AD and ED eyes in suspect eyes only. Change location is primarily temporal and inferior in all diagnostic groups.
Figure 4.
Figure 4.
Distributions of the global restinal nerve fiber layer (RNFL) thickness estimated rates of change over time (μm/year) for African descent (AD) and European descent (ED) eyes in healthy (left), glaucoma suspect (center) and glaucoma (right) eyes. No significant differences between AD and ED eyes were observed in any diagnostic category.
Figure 5.
Figure 5.
Pie charts showing global retinal nerve fiber layer (RNFL) thickness estimated rates of change over time (μm/year) by sector for African descent (AD) and European descent (ED) eyes in healthy (left), glaucoma suspect (center) and glaucoma (right) eyes. No significant differences between AD and ED eyes were observed in any diagnostic category. Patterns of change vary across all diagnostic groups.
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