Background/Aims To investigate racial differences in the variability of longitudinal visual field testing in a ‘real-world’ clinical population, evaluate how these differences are influenced by socioeconomic status, and estimate the impact of differences in variability on the time to detect visual field progression. Methods This retrospective observational cohort study used data from 1103 eyes from 751 White individuals and 428 eyes from 317 black individuals. Linear regression was performed on the standard automated perimetry mean deviation values for each eye over time. The SD of the residuals from the trend lines was calculated and used as a measure of variability for each eye. The association of race with the SD of the residuals was evaluated using a multivariable generalised estimating equation model with an interaction between race and zip code income. Computer simulations were used to estimate the time to detect visual field progression in the two racial groups. Results Black patients had larger visual field variability over time compared with white patients, even when adjusting for zip code level socioeconomic variables (SD of residuals for Black patients=1.53 dB (95% CI 1.43 to 1.64); for white patients=1.26 dB (95% CI 1.14 to 1.22); mean difference: 0.28 (95% CI 0.15 to 0.41); p<0.001). The difference in visual field variability between black and white patients was greater at lower levels of income and led to a delay in detection of glaucoma progression. Conclusion Black patients had larger visual field variability compared with white patients. This relationship was strongly influenced by socioeconomic status and may partially explain racial disparities in glaucoma outcomes. Data are available on reasonable request. The Duke Glaucoma Registry data are maintained on HIPAA-compliant servers at Duke University.

中文翻译：

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纵向视野变异性和检测黑人和白人青光眼进展的能力

背景/目的 调查“真实世界”临床人群中纵向视野测试变异性的种族差异，评估这些差异如何受到社会经济地位的影响，并估计变异性差异对视野检测时间的影响进展。方法 这项回顾性观察队列研究使用了 751 名白人的 1103 只眼睛和 317 名黑人的 428 只眼睛的数据。随着时间的推移，对每只眼睛的标准自动视野检查平均偏差值进行线性回归。计算趋势线残差的 SD 并将其用作每只眼睛的变异性度量。使用多变量广义估计方程模型以及种族和邮政编码收入之间的相互作用来评估种族与残差 SD 的关联。使用计算机模拟来估计检测两个种族群体的视野进展的时间。结果 与白人患者相比，黑人患者随时间的视野变化更大，即使调整了邮政编码水平的社会经济变量（黑人患者残差标准差 = 1.53 dB（95% CI 1.43 至 1.64）；白人患者 = 1.26 dB（ 95% CI 1.14 至 1.22)；平均差：0.28（95% CI 0.15 至 0.41）；p<0.001）。在收入水平较低的情况下，黑人和白人患者的视野变异性差异更大，导致青光眼进展检测的延迟。结论 与白人患者相比，黑人患者的视野变异性更大。这种关系受到社会经济地位的强烈影响，并可能部分解释青光眼结果的种族差异。可根据合理要求提供数据。杜克青光眼登记数据保存在杜克大学符合 HIPAA 标准的服务器上。