Background To examine long-term retinal nerve fibre layer thickness (RNFLT) variability and associated clinical factors in African (AD) and European descent (ED) individuals with glaucoma. Methods This retrospective cohort study included glaucoma eyes of AD and ED from Diagnostic Innovations in Glaucoma Study/The African Descent and Glaucoma Evaluation Study with ≥4 visits/2 years of follow-up. We calculated optic nerve head RNFLT variability per-examination/visit as the absolute error of its residuals across follow-up. Full, baseline and parsimonious linear-mixed models were fit to evaluate the effects of clinical factors (demographics and ocular characteristics, prior/intervening glaucoma surgeries and cataract extraction (CE), RNFLT thinning rate, scan quality, visit/testing frequency, etc) on RNFLT variability in both races. Results There were 376 and 625 eyes (226 and 349 participants) of AD and ED, and the mean (95% CI) RNFLT variability was 1.62 (1.52, 1.71) µm and 1.42 (1.34, 1.50) µm, respectively (p=0.002). AD and ED had some shared predictors of RNFLT variability, including intraocular pressure fluctuation and scan quality, although the effects varied (p<0.05). In both races, intervening CE was most strongly correlated with higher RNFLT variability (β: 0.24–0.92, p<0.05). After excluding eyes with intervening CE, RNFLT variability was reduced and the small racial difference was no longer significant (AD: 1.40 (1.31, 1.48) µm vs ED: 1.34 (1.27, 1.40) µm; p=0.280). Conclusions Although some predictors were identified, long-term RNFLT variability appeared small for both AD and ED eyes. Moreover, the racial difference did not remain once intervening CE, the strongest predictor of variability, was eliminated. Our findings inform on strategies to optimise structural assessment and suggest that, when accounting for relevant factors, RNFLT is reliable across races. Data are available upon reasonable request. Data are available on reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

中文翻译：

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非洲和欧洲血统青光眼患者视网膜神经纤维层厚度测量的长期变异性


背景 旨在检查非洲 (AD) 和欧洲血统 (ED) 青光眼患者的长期视网膜神经纤维层厚度 (RNFLT) 变异性和相关临床因素。方法 这项回顾性队列研究包括来自青光眼诊断创新研究/非洲人后裔和青光眼评估研究的 AD 和 ED 青光眼眼，随访次数≥4 次/2 年随访。我们将每次检查/就诊的视神经乳头 RNFLT 变异性计算为随访期间残差的绝对误差。完整、基线和简约线性混合模型适合评估临床因素的影响（人口统计学和眼部特征、既往/干预青光眼手术和白内障摘除术（CE）、RNFLT 稀疏率、扫描质量、就诊/测试频率等）两个种族的 RNFLT 变异性。结果 AD 和 ED 分别有 376 和 625 只眼睛（226 和 349 名参与者），平均 (95% CI) RNFLT 变异性分别为 1.62 (1.52, 1.71) µm 和 1.42 (1.34, 1.50) µm (p=0.002) ）。 AD 和 ED 对 RNFLT 变异性有一些共同的预测因子，包括眼压波动和扫描质量，尽管效果各不相同 (p<0.05)。在两个种族中，干预 CE 与较高的 RNFLT 变异性相关性最强（β：0.24-0.92，p<0.05）。排除干预 CE 的眼睛后，RNFLT 变异性降低，小的种族差异不再显着（AD：1.40 (1.31, 1.48) µm vs ED：1.34 (1.27, 1.40) µm；p=0.280）。结论 尽管确定了一些预测因子，但 AD 和 ED 眼的长期 RNFLT 变异性似乎都很小。此外，一旦消除了干预性CE（变异性最强的预测因子），种族差异就不再存在。 我们的研究结果为优化结构评估的策略提供了信息，并表明，在考虑相关因素时，RNFLT 在各个种族中都是可靠的。数据可根据合理要求提供。可根据合理要求提供数据。当前研究期间生成和/或分析的数据集可根据合理要求从相应作者处获得。