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Racial Differences in Optic Disc Topography
Baseline Results From the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study
Linda M. Zangwill, PhD;
Robert N. Weinreb, MD;
Charles C. Berry, PhD;
Amanda R. Smith, MPH;
Keri A. Dirkes, MPH;
Anne L. Coleman, MD, PhD;
Jody R. Piltz-Seymour, MD;
Jeffrey M. Liebmann, MD;
George A. Cioffi, MD;
Gary Trick, PhD;
James D. Brandt, MD;
Mae O. Gordon, PhD;
Michael A. Kass, MD; for the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study
Arch Ophthalmol. 2004;122:22-28.
Objective To examine racial differences in optic disc topography among ocular hypertensive participants in the Ocular Hypertension Treatment Study.
Methods Four hundred thirty-nine participants from 7 Ocular Hypertension Treatment Study centers who had good-quality baseline images obtained using a quantitative 3-dimensional confocal scanning laser ophthalmoscope, the Heidelberg Retina Tomograph (Heidelberg Engineering, Dossenheim, Germany), were included in this study. The first 10°- or 15°-field of view mean topographic image acquired was included in all analyses. Differences in Heidelberg Retina Tomograph topographic optic disc parameter measurements by self-identified race were assessed using a mixed-effects linear model to control for confounders and for the use of both eyes in the model.
Results By self-attribution, 74 (17%) of the 439 participants were of African origin, 329 (75%) were white, 24 (5%) were Hispanic, and 12 (3%) were Native American, Native Alaskan, Asian, Pacific Islander, or unknown. The African American participants had statistically significantly (P<.001) larger mean (SD) optic disc areas than the other participants, 2.17 (0.41) mm2 vs 1.87 (0.38) mm2, respectively. African American participants had a larger cup area, cup volume, cup depth, neuroretinal rim area, rim volume, and smaller rim–optic disc area ratios than the other participants. No difference between African American and the other participants was found for cup shape and retinal nerve fiber layer thickness. After controlling for optic disc area, none of the differences between African American and the other participants found in the univariate analysis remained statistically significant (P>.10).
Conclusions This study demonstrated in a large cohort of subjects with ocular hypertension, that African Americans have significantly larger optic discs, optic cups, neuroretinal rims, and cup-disc ratios than other racial groups. Furthermore, this study found that differences in topographic optic disc parameters between African Americans with ocular hypertension and other racial groups are largely explained by the larger optic disc area in the African Americans. These results highlight the need to consider race and optic disc size when evaluating the appearance of the optic disc in glaucoma.
From the Departments of Ophthalmology (Drs Zangwill and Weinreb and Mss Smith and Dirkes) and Family and Preventive Medicine (Dr Berry), University of California, San Diego, La Jolla; Jules Stein Eye Institute, University of California, Los Angeles (Dr Coleman); Scheie Eye Institute, University of Pennsylvania, Philadelphia (Dr Piltz-Seymour); New York Eye and Ear Infirmary, New York (Dr Liebmann); Devers Eye Institute, Portland, Ore (Dr Cioffi); Henry Ford Medical Center, Troy, Mich (Dr Trick); University of California, Davis, Sacramento (Dr Brandt); and the Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Mo (Drs Gordon and Kass).
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