TY - JOUR
T1 - The advanced glaucoma intervention study (AGIS)
T2 - 9. Comparison of glaucoma outcomes in black and white patients within treatment groups
AU - AGIS Investigators
AU - Ederer, Fred
AU - VanVeldhuisen, Paul C.
AU - Dally, Leonard G.
AU - Gaasterland, Douglas E.
AU - Sullivan, E. Kenneth
AU - Vela, M. Angela
AU - Schwartz, Arthur L.
AU - Blackwell, Elizabeth
AU - Miller, Eydie
AU - Shields, M. Bruce
AU - Sonty, Sriram
AU - Shafranov, George
AU - Beck, Allen
AU - Costarides, Anastasios
AU - Leef, Donna
AU - Closek, John
AU - Banks, Juanita
AU - Jackson, Sheena
AU - Moore, Kathy
AU - Brown, Reay H.
AU - Lynch, Mary
AU - Gunsby, Johnny
AU - Lober, Kathy
AU - Marsh, Twyla
AU - Stepka, Candace
AU - Montgomery, Robin
AU - Clagett, Donna
AU - Ashburn, Frank
AU - Schacht, Karen
AU - Coyle, Ellen
AU - Garland, Melissa Kellogg
AU - Lauber, Susan
AU - Michelitsch, Karl
AU - Plavnieks, Suzanne
AU - Vayer, Lynn
AU - Burt, Elizabeth
AU - Hundley, Mary
AU - Rae, Anne
AU - Allen, Robert C.
AU - Sporn, Amy
AU - Fendley, C. Kay
AU - Hoyle, L. Sharon
AU - Weber, Paul A.
AU - McKinney, Kathryne
AU - Moore, Diane
AU - Baker, N. Douglas
AU - Kapetansky, Fred
AU - Lehmann, David
AU - Lauderbaugh, Tammy
AU - Connett, John E.
N1 - Publisher Copyright:
© 2001 by Elsevier Science Inc. All rights reserved.
PY - 2001
Y1 - 2001
N2 - PURPOSE: To compare in eyes of black and white patients the progression of glaucoma after failure of medical therapy and upon start of surgical intervention. • DESIGN: Cohort study analysis of data from a randomized clinical trial. • METHODS: This multicenter study included open-angle glaucoma patients who had failed medical therapy: 451 eyes of 332 black patients, 325 eyes of 249 white patients. Eyes were randomly assigned to an argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence; they had been followed for 7 to 11 years at database closure. Main outcome measures were decrease of visual field (DVF), sustained decrease of visual field (SDVF), decrease of visual acuity (DVA), sustained decrease of visual acuity (SDVA), and failure of first surgical glaucoma intervention. Statistical methods included logistic regression to obtain average adjusted black-white odds ratios for binary outcomes, and Cox regression to estimate adjusted black-white risk ratios for time-to-event outcomes. • RESULTS: In the ATT sequence blacks were at lower risk than whites of failure of first intervention (ALT, RR = 0.68, P = 0.040). In the TAT sequence blacks were at higher risk than whites of failure of the first intervention (trabeculectomy, RR = 1.79, P 5 0.033), of intraocular pressure ≥18 mm Hg (average OR = 1.41, P = 0.026), and of DVF (average OR = 1.78, P = 0.007). In both treatment sequences, the average number of prescribed medications was greater for blacks than whites (P ≤ 0.002). • CONCLUSIONS: The results support the hypothesis that after failure of medical therapy and upon initiation of surgical intervention, an initial intervention with trabeculectomy retards the progression of glaucoma more effectively in white than in black patients. The data provide a weak suggestion that an initial surgical intervention with ALT retards the progression of glaucoma more effectively in black than in white patients.
AB - PURPOSE: To compare in eyes of black and white patients the progression of glaucoma after failure of medical therapy and upon start of surgical intervention. • DESIGN: Cohort study analysis of data from a randomized clinical trial. • METHODS: This multicenter study included open-angle glaucoma patients who had failed medical therapy: 451 eyes of 332 black patients, 325 eyes of 249 white patients. Eyes were randomly assigned to an argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence; they had been followed for 7 to 11 years at database closure. Main outcome measures were decrease of visual field (DVF), sustained decrease of visual field (SDVF), decrease of visual acuity (DVA), sustained decrease of visual acuity (SDVA), and failure of first surgical glaucoma intervention. Statistical methods included logistic regression to obtain average adjusted black-white odds ratios for binary outcomes, and Cox regression to estimate adjusted black-white risk ratios for time-to-event outcomes. • RESULTS: In the ATT sequence blacks were at lower risk than whites of failure of first intervention (ALT, RR = 0.68, P = 0.040). In the TAT sequence blacks were at higher risk than whites of failure of the first intervention (trabeculectomy, RR = 1.79, P 5 0.033), of intraocular pressure ≥18 mm Hg (average OR = 1.41, P = 0.026), and of DVF (average OR = 1.78, P = 0.007). In both treatment sequences, the average number of prescribed medications was greater for blacks than whites (P ≤ 0.002). • CONCLUSIONS: The results support the hypothesis that after failure of medical therapy and upon initiation of surgical intervention, an initial intervention with trabeculectomy retards the progression of glaucoma more effectively in white than in black patients. The data provide a weak suggestion that an initial surgical intervention with ALT retards the progression of glaucoma more effectively in black than in white patients.
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U2 - 10.1016/S0002-9394(01)01028-5
DO - 10.1016/S0002-9394(01)01028-5
M3 - Article
C2 - 11530042
AN - SCOPUS:0034886507
SN - 0002-9394
VL - 132
SP - 311
EP - 320
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 3
ER -