AbstractThis study assessed the impact of race and ethnicity on longitudinal test variability and time to detect glaucoma progression using standard automated perimetry (SAP) and optical coherence tomography (OCT). The sample consisted of 47,003 SAP tests from 5402 eyes and 25,480 OCT tests from 4125 eyes, with 20% of participants self-identifying as Black or African American and 80% as White; 29% as Hispanic or Latino and 71% as Not Hispanic or Latino.

摘要本研究使用标准自动视野检查（SAP）和光学相干断层扫描（OCT）评估了种族和种族对纵向测试变异性和检测青光眼进展时间的影响。样本包括来自5402只眼睛的47003次SAP测试和来自4125只眼睛的25480次OCT测试，其中20%的参与者自我识别为黑人或非裔美国人，80%为白人；29%为西班牙裔或拉丁裔，71%为非西班牙裔或拉丁裔。

Variability was measured using standard deviations of residuals from linear regression models for SAP mean deviation (MD) and OCT retinal nerve fiber layer (RNFL) thickness over time. Results showed significantly greater SAP variability in Black or African American (1.80 ± 1.30 dB) compared to White participants (1.56 ± 1.21 dB; P < 0.001) and in Hispanic or Latino (1.81 ± 1.46 dB) compared to Not Hispanic or Latino individuals (1.52 ± 1.10 dB; P < 0.001).

使用SAP平均偏差（MD）和OCT视网膜神经纤维层（RNFL）厚度随时间变化的线性回归模型的残差标准差来测量变异性。结果显示，与白人参与者（1.56±1.21 dB；P<0.001）和西班牙裔或拉丁裔（1.81±1.46 dB）相比，黑人或非裔美国人（1.80±1.30 dB）的SAP变异性显着高于非西班牙裔或拉丁裔（1.52±1.10 dB；P<0.001）。

OCT variability was higher in Black or African American (2.3 ± 1.5 μm) compared to White (2.1 ± 1.3 μm; P < 0.001) and in Not Hispanic or Latino (2.2 ± 1.3 μm) compared to Hispanic or Latino (2.1 ± 1.2 μm; P = 0.029). Increased SAP variability delayed progression detection, while OCT showed minimal differences.

黑人或非裔美国人（2.3±1.5μm）的OCT变异性高于白人（2.1±1.3μm）；与西班牙裔或拉丁裔（2.1±1.2μm）相比，P<0.001）和非西班牙裔或拉丁裔（2.2±1.3μm）；P=0.029）。SAP变异性增加延迟了进展检测，而OCT显示最小差异。

These findings suggest that higher perimetric variability in Black or African American and Hispanic or Latino may affect glaucoma progression detection using SAP..

这些发现表明，黑人或非裔美国人以及西班牙裔或拉丁裔的周长变异性较高可能会影响使用SAP检测青光眼进展。。

IntroductionGlaucoma is a chronic optic neuropathy and the leading cause of irreversible blindness worldwide1. While the development and progression of this disease can be influenced by multiple factors1, the impact of racial and ethnic differences remains a complex and poorly understood aspect. The exact causes of these differences have not yet been elucidated2.Population-based studies in diverse settings have confirmed that glaucoma is more prevalent in Black or African American individuals compared to White individuals3,4,5,6.

引言青光眼是一种慢性视神经病变，是全球不可逆失明的主要原因1。虽然这种疾病的发展和进展可能受到多种因素的影响1，但种族和民族差异的影响仍然是一个复杂且知之甚少的方面。这些差异的确切原因尚未阐明2。在不同环境中进行的基于人群的研究证实，与白人相比，黑人或非裔美国人的青光眼更为普遍3,4,5,6。

In addition to increased prevalence, glaucoma can lead to a disproportionately higher rate of visual impairment in the former group7,8,9,10. In a series of earlier investigations, we hypothesized that increased variability in standard automated perimetry (SAP) testing in Black or African American individuals might contribute to explain some of the observed disparities.

除了患病率增加外，青光眼还可能导致前一组视力障碍的发生率过高7,8,9,10。在一系列早期的调查中，我们假设黑人或非裔美国人的标准自动视野检查（SAP）测试的变异性增加可能有助于解释一些观察到的差异。

This increased variability could lead to delays in detecting progressive damage, resulting in postponed interventions and consequently higher rates of visual impairment11,12. Although the underlying causes of increased SAP variability among Black or African American subjects remain unclear, they could be associated with poorer socioeconomic conditions commonly experienced by this group and potential effects of systemic racism in test administration procedures11,12.Previous studies have shown that Hispanics and Latinos are also at higher risk for visual impairment from glaucoma10,13,14.

这种增加的可变性可能导致延迟检测进行性损伤，导致干预延迟，从而导致视力障碍发生率更高11,12。虽然黑人或非裔美国人受试者SAP变异性增加的根本原因尚不清楚，但它们可能与该群体通常经历的较差的社会经济条件以及测试管理程序中系统性种族主义的潜在影响有关11,12。以前的研究表明，西班牙裔和拉丁裔也有较高的青光眼视力障碍风险10,13,14。

It is possible that issues related to test-retest variability may also affect the ability of clinicians to diagnose glaucoma progression in these groups, which could explain, at least in part, differences in outcomes. However, to the best of our knowledge, this hypothesis has not been tested.The cu.

与重测变异性相关的问题也可能影响临床医生诊断这些组青光眼进展的能力，这至少可以部分解释结果的差异。然而，据我们所知，这一假设尚未得到检验。cu。

Data availability

数据可用性

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Access to the data is restricted due to privacy and ethical considerations.

在当前研究期间生成和/或分析的数据集可根据合理要求从通讯作者处获得。出于隐私和道德考虑，对数据的访问受到限制。

AbbreviationsBPGR:

缩写BPGR：

Bascom palmer glaucoma repository

Bascom palmer青光眼存储库

HFA:

HFA：

Humphrey visual field analyzer

汉弗莱视野分析仪

ICD:

ICD ：

International classification of diseases

国际疾病分类

MD:

医学博士：

mean deviation

平均偏差

OAG:

OAG：

open-angle glaucoma

开角型青光眼

OCT:

10月：

optical coherence tomography

光学相干断层扫描

RNFL:

RNFL ：

retinal nerve fiber layer thickness

视网膜神经纤维层厚度

SAP:

SAP：

standard automated perimetry

标准自动视野检查

SD:

标准差：

standard deviation

标准偏差

SITA:

锡塔：

Swedish interactive thresholding algorithm

瑞典交互式阈值分割算法

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Wu, Z. et al. Impact of normal aging and progression definitions on the specificity of detecting retinal nerve Fiber layer thinning. Am. J. Ophthalmol. 181, 106–113. https://doi.org/10.1016/j.ajo.2017.06.017 (2017).Article

Wu，Z.等人。正常衰老和进展定义对检测视网膜神经纤维层变薄的特异性的影响。美国眼科杂志。。https://doi.org/10.1016/j.ajo.2017.06.017（2017年）。文章

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Download referencesFundingSupported in part by National Institutes of Health (NIH)/National Eye Institute (NEI) grant EY029885 (FAM), K23 EY033831 (SSS), American Glaucoma Society Mentoring for the Advancement of Physician Scientists Award (SSS), and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Brazil) Finance Code 001 (LAFB).

下载部分由美国国立卫生研究院（NIH）/国家眼科研究所（NEI）资助的参考基金EY029885（FAM），K23 EY033831（SSS），美国青光眼学会医师科学家进步指导奖（SSS）和高级佩索阿尔基金会（巴西卡佩斯）财务代码001（LAFB）。

The funding organizations had no role in the design or conduct of this research.Author informationAuthors and AffiliationsBascom Palmer Eye Institute, University of Miami, 900 NW 17th St, Miami, FL, USALuiz A. F. Beniz, Alessandro A. Jammal, Douglas R. da Costa, Swarup S. Swaminathan & Felipe A. MedeirosDepartment of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, BrazilLuiz A.

资助组织在这项研究的设计或进行中没有任何作用。作者信息作者和附属机构迈阿密大学巴斯克·帕尔默眼科研究所，佛罗里达州迈阿密西北第17街900号，USALuiz A.F.Beniz，亚历山德罗A.Jammal，道格拉斯R.da Costa，Swarup S.Swaminathan＆FelipeA.Medeiros圣保罗联邦大学保罗医学院眼科和视觉科学系，圣保罗，巴西。

F. Beniz & Eduardo B. MariottoniAuthorsLuiz A. F. BenizView author publicationsYou can also search for this author in.

F、 Beniz＆EduardoB.MariottoniauthorsLuizA.F.BenizView作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarAlessandro A. JammalView author publicationsYou can also search for this author in

PubMed Google ScholarAlessandro A.JammalView作者出版物您也可以在

PubMed Google ScholarDouglas R. da CostaView author publicationsYou can also search for this author in

PubMed Google ScholarDouglas R.da CostaView作者出版物您也可以在

PubMed Google ScholarEduardo B. MariottoniView author publicationsYou can also search for this author in

PubMed Google ScholarEduardo B.MariottoniView作者出版物您也可以在

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PubMed Google ScholarContributionsF.A.M. conceived and designed the study described; L.A.F.B., A.A.J., D.R.C., E.B.M., S.S.S., and F.A.M. collected and managed the data; L.A.F.B., A.A.J., and F.A.M. performed data analyses and interpretation; L.A.F.B., A.A.J., D.R.C., E.B.M., S.S.S., and F.A.M.

PubMed谷歌学术贡献。A、 M.构思并设计了所描述的研究；五十、 ；五十、 A.F.B.，A.A.J。和F.A.M.进行了数据分析和解释；五十、 A.F.B.，A.A.J.，D.R.C.，E.B.M.，S.S.S。和F.A.M。

drafted and revised the manuscript prior to submission.Corresponding authorCorrespondence to.

在提交之前起草并修订了稿件。对应作者对应。

Felipe A. Medeiros.Ethics declarations

费利佩·A·梅代罗斯。伦理声明

Competing interests

相互竞争的利益

L.A.F.B.: none. A.A.J.: none. D.R.C.: none. E.B.M.: none. S.S.S.: Heidelberg Engineering (S), Lumata Health (C, E), Abbvie (C); Topcon (C). F.A.M.: AbbVie (C), Annexon (C); Carl Zeiss Meditec (C), Galimedix (C); Google Inc. (F); Heidelberg Engineering (F), nGoggle Inc. (P), Novartis (F); ONL Therapeutics (C), Stealth Biotherapeutics (C); Stuart Therapeutics (C), Thea Pharmaceuticals (C), Reichert (C, F)..

五十、 A.F.B.：无。A、 A.J.：没有。D、 R.C.：无。E、 B.M.：没有。S、 S.S.：海德堡工程（S），卢马塔健康（C，E），艾伯维（C）；。F、 上午：AbbVie（C），附录（C）；Carl Zeiss Meditec（C），Galimedix（C）；谷歌公司（F）；海德堡工程（F）、恩格尔公司（P）、诺华（F）；ONL Therapeutics（C），Stealth Biotherapeutics（C）；斯图尔特治疗学（C），西阿制药（C），瑞切特（C，F）。。

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Reprints and permissionsAbout this articleCite this articleBeniz, L.A.F., Jammal, A.A., da Costa, D.R. et al. Impact of race and ethnicity on glaucoma progression detection by perimetry and optical coherence tomography.

转载和许可本文引用本文Beniz，L.A.F.，Jammal，A.A.，da Costa，D.R。等人。种族和种族对视野检查和光学相干断层扫描检测青光眼进展的影响。

Sci Rep 14, 30752 (2024). https://doi.org/10.1038/s41598-024-80481-4Download citationReceived: 05 September 2024Accepted: 19 November 2024Published: 28 December 2024DOI: https://doi.org/10.1038/s41598-024-80481-4Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Sci Rep 1430752（2024）。https://doi.org/10.1038/s41598-024-80481-4Download引文接收日期：2024年9月5日接受日期：2024年11月19日发布日期：2024年12月28日OI：https://doi.org/10.1038/s41598-024-80481-4Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsRaceEthnicityGlaucoma progressionPerimetryVisual fieldOptical coherence tomography.

关键词种族青光眼进展视野光学相干断层扫描。