{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:13:45Z","timestamp":1789478025151,"version":"build-2803163510"},"reference-count":61,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T00:00:00Z","timestamp":1694822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Eye Institute, Bethesda, Maryland","award":["#1R01EY023557-01"],"award-info":[{"award-number":["#1R01EY023557-01"]}]},{"name":"National Eye Institute, Bethesda, Maryland","award":["P30 EY001583"],"award-info":[{"award-number":["P30 EY001583"]}]},{"DOI":"10.13039\/100000053","name":"Vision Research Core Grant","doi-asserted-by":"publisher","award":["#1R01EY023557-01"],"award-info":[{"award-number":["#1R01EY023557-01"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000053","name":"Vision Research Core Grant","doi-asserted-by":"publisher","award":["P30 EY001583"],"award-info":[{"award-number":["P30 EY001583"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kirby Foundation","award":["#1R01EY023557-01"],"award-info":[{"award-number":["#1R01EY023557-01"]}]},{"name":"Kirby Foundation","award":["P30 EY001583"],"award-info":[{"award-number":["P30 EY001583"]}]},{"name":"Research to Prevent Blindness","award":["#1R01EY023557-01"],"award-info":[{"award-number":["#1R01EY023557-01"]}]},{"name":"Research to Prevent Blindness","award":["P30 EY001583"],"award-info":[{"award-number":["P30 EY001583"]}]},{"name":"UPenn Hospital Board of Women Visitors","award":["#1R01EY023557-01"],"award-info":[{"award-number":["#1R01EY023557-01"]}]},{"name":"UPenn Hospital Board of Women Visitors","award":["P30 EY001583"],"award-info":[{"award-number":["P30 EY001583"]}]},{"name":"Paul and Evanina Bell Mackall Foundation Trust","award":["#1R01EY023557-01"],"award-info":[{"award-number":["#1R01EY023557-01"]}]},{"name":"Paul and Evanina Bell Mackall Foundation Trust","award":["P30 EY001583"],"award-info":[{"award-number":["P30 EY001583"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Genes"],"abstract":"<jats:p>Background\/Aims: Primary open-angle glaucoma (POAG) disproportionately affects individuals of African ancestry. In these patients\u2019 eyes, a large cup-to-disc ratio (LCDR &gt; 0.90) suggests greater retinal ganglion cell loss, though these patients often display varied visual ability. This study investigated the prevalence and risk factors associated with LCDR in African ancestry individuals with POAG and explored the differences between blind (&gt;20\/200) and not blind (\u226420\/200) LCDR eyes. Methods: A case\u2013control methodology was used to investigate the demographic, optic disc, and genetic risk factors of subjects in the Primary Open-Angle African American Glaucoma Genetics Study. Risk factors were analyzed using univariable and multivariable logistic regression models with inter-eye correlation adjusted using generalized estimating equations. Results: Out of 5605 eyes with POAG, 1440 eyes (25.7%) had LCDR. In the multivariable analysis, LCDR was associated with previous glaucoma surgery (OR = 1.72), increased intraocular pressure (OR = 1.04), decreased mean deviation (OR = 1.08), increased pattern standard deviation (OR = 1.06), thinner retinal nerve fiber layer (OR = 1.05), nasalization of vessels (OR = 2.67), bayonetting of vessels (OR = 1.98), visible pores in the lamina cribrosa (OR = 1.68), and a bean-shaped cup (OR = 2.11). Of LCDR eyes, 30.1% were classified as blind (\u226420\/200). In the multivariable analysis, the statistically significant risk factors of blindness in LCDR eyes were previous glaucoma surgery (OR = 1.72), increased intraocular pressure (OR = 1.05), decreased mean deviation (OR = 1.04), and decreased pattern standard deviation (OR = 0.90). Conclusions: These findings underscore the importance of close monitoring of intraocular pressure and visual function in African ancestry POAG patients, particularly those with LCDR, to preserve visual function.<\/jats:p>","DOI":"10.3390\/genes14091809","type":"journal-article","created":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T06:36:45Z","timestamp":1694932605000},"page":"1809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Factors Associated with Large Cup-to-Disc Ratio and Blindness in the Primary Open-Angle African American Glaucoma Genetics (POAAGG) Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Anusha","family":"Mamidipaka","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Di Rosa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yineng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Salowe","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Addis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prithvi","family":"Sankar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebenezer","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui-Shuang","family":"Ying","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan M.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1016\/S2214-109X(20)30425-3","article-title":"Trends in Prevalence of Blindness and Distance and near Vision Impairment over 30 Years: An Analysis for the Global Burden of Disease Study","volume":"9","author":"Bourne","year":"2021","journal-title":"Lancet Glob. 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