Structural Changes in Glaucoma Differ Between Ethnic Groups

Shot of a young woman getting her eye’s examined with a slit lamp
Researchers identify racial differences in glaucomatous changes to the structure of the lamina cribrosa.

Glaucomatous remodeling of the lamina cribrosa differs between patients of African descent and patients of European descent. Further, the greater posterior shift in anterior lamina cribrosa surface depth seen in patients of European descent differs from the changes reported with normal aging, according to researchers.

Building on their previous research that demonstrated that the mechanical behavior of the healthy optic nerve head in response to intraocular pressure changes differs between patients of African descent and European descent, investigators sought to determine if the rate of change in the depth of the surface of the lamina cribrosa due to glaucomatous remodeling differs between the two ethnic groups.

They reviewed 1122 images taken longitudinally spanning an average of 3 years from 122 patients with glaucoma followed in the African Descent and Glaucoma Evaluation Study (ADAGES) and Diagnostic Intervention and Glaucoma Study (DIGS). The rate of anterior lamina cribrosa surface depth (ALCSD) change was compared across racial groups after adjusting for baseline characteristics known to be associated with ALCSD or disease progression. They found that the European group had significantly greater ALCSD posterior migration (deepening) than the group of African descent (difference=2.57 μm/year, P =.035). In addition, there was a wider range of ALCSD change in the European descent group compared with the African descent group, and more patients had a greater magnitude of both deepening and shallowing. According to researchers, no other covariates measured at baseline had independent effects on the longitudinal changes in ALCSD.

Researchers note several limitations to their work, including the difference in age between the racial groups, with an older and broader range of ages in the European group. Additionally, there are limitations with self-described racial categorization.

Disclosure: Several authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Girkin CA, Belghith A, Bowd C, et al. Racial differences in the rate of change in anterior lamina cribrosa surface depth in the African descent and glaucoma evaluation study. Invest Ophthalmol Vis Sci. 2021;62(4):12. doi:10.1167/iovs.62.4.12