African Americans with Glaucoma: Structure and Function

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DESCRIPTION (provided by applicant): Glaucoma, which is 5 times more likely to occur in Blacks than Whites, is the leading cause of irreversible blindness in Blacks. Little is known about whether new diagnostic tests including vision function specific tests and optic disc and retinal nerve fiber layer imaging can improve our ability to detect and monitor glaucoma in the Black population. Purpose: To systematically assess and compare new diagnostic techniques in Black and White participants. Aims: To compare differences in visual function tests and measures of optic nerve structure in normal, ocular hypertensive, and glaucomatous Black and White participants, to determine whether function specific perimetry tests show improved diagnosis in Blacks as they do in Whites, and to compare the rate and patterns of progression of glaucomatous damage in the two racial groups. Participants: 125 normal and 275 Black participants with glaucoma. Methods: Black participants will be recruited primarily from New York Eye and Ear Infinnary and the University of Alabama Glaucoma Service. White participants are recruited under separate funding at UC San Diego. UC San Diego serves as a Reading Center for data processing, quality control and analysis for this study. The glaucomatous eyes will be followed with annual testing for 5 years. Visual fields will include standard clinical perimetry, and two function-specific tests, Short-wavelength Automated Perimetry and Frequency Doubling Technology Perimetry. Optic nerve structure will be qualitatively evaluated with stereoscopic fundus photography and quantitatively using the Heidelberg Retina Tomograph and Optical Coherence Tomograph. Comparisons between Blacks and Whites will be made on each test and between the measures of function and structure. Importance: At study conclusion, practitioners should understand any differences in visual function and optic nerve structure between White and Black patients and how to account for them when interpreting the results. A greater understanding of the importance of race for development and progression of glaucoma will result leading to more precise endpoints for future clinical trials with this at-risk minority population.