Risk factors associated with beta-peripapillary atrophy in individuals of African ancestry with primary open-angle glaucoma

Eye · 2025-10-07 · 1 citations

BACKGROUND: Beta-Peripapillary Atrophy (beta-PPA) is an optic nerve head change associated with primary open-angle glaucoma (POAG). We evaluated demographic, ocular, and genetic risk factors for beta-PPA in individuals of African ancestry with POAG. METHODS: POAG cases were recruited from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Beta-PPA was defined as hypopigmentation with visible choroidal vessels and sclera adjacent to the optic disc. Univariable and multivariable regression models assessed risk factors for the presence and extent of beta-PPA. RESULTS: Among 3381 eyes, 969 (28.6%) had beta-PPA. Beta-PPA was associated with older age (OR = 2.90, p < 0.001) and larger vertical cup-to-disc ratio (CDR) (OR = 1.58, p = 0.007), and was less common in females (OR = 0.53, p < 0.001). Beta-PPA presence was negatively associated with grey crescent (OR = 0.47, p = 0.01), neural rim notching (OR = 0.43, p = 0.01), and cylindrical (OR = 0.55, p < 0.001) or bean pot cup shapes (OR = 0.59, p < 0.001). Larger beta-PPA area was linked to older age (p = 0.008) and large vertical CDR (p = 0.03), but was less likely with conus pigmentosus (p = 0.001), deeper cup depth (p = 0.006), higher IOP (p = 0.005), and rounder discs (p = 0.01). Higher polygenic risk score (p = 0.007) and presence of the SNP rs34957764 in ROCK1P1 (p = 0.053) were associated with beta-PPA, but the same SNP was also associated with lesser area of beta-PPA (p = 0.03). Regions of beta-PPA correlated with greater RNFL loss (p < 0.01). CONCLUSIONS: Beta-PPA is strongly associated with older age and high CDR among individuals with POAG. These regions are vulnerable to RNFL loss.

Robot-assisted laparoscopic pyeloplasty in horseshoe kidney (with isthmus division and lateral nephropexy)

European Urology Open Science · 2025-09-01

Sloping retina: a novel feature associated with primary open-angle glaucoma in an African ancestry cohort

BMJ Open Ophthalmology · 2025-08-01 · 1 citations

OBJECTIVE: To define sloping of the retina, a novel stereoscopic feature in primary open-angle glaucoma (POAG), and to evaluate its prevalence and associated risk factors in an African ancestry population. METHODS AND ANALYSIS: Digital stereo disc images were graded for sloping by trained non-physician graders. We defined a sloping retina as one that slanted downward towards the disc margin instead of existing on the same plane as the disc margin. A 'sloping retina' approached the disc margin at an angle along at least one-third of the disc's circumference. The ocular and demographic risk factors of sloping were evaluated by univariable and multivariable logistic regression models. RESULTS: The prevalence of sloping in eyes with POAG was 22.0% (95% CI 20.6% to 23.4%). In a multivariable analysis, compared with eyes without sloping, eyes with sloping were less likely to have disc haemorrhages (p=0.03) and more likely to have a tilted disc (p<0.001), larger cup-to-disc ratio ((defined as 0.7-1), p=0.002), grey crescent (p=0.02), nasalisation of the vessels (p=0.01), moderate or deep cup depth (p<0.001) and conical cup shape (p<0.001). Sloping was not associated with any demographic characteristics in the multivariable analysis. CONCLUSION: Associated with risk factors of advanced POAG, sloping presents as a novel feature that warrants further study to determine its mechanisms of development and prevalence in other study populations. Study limitations include: large difference in the number of eyes with and without sloping, potential morphological expressions of other phenotypes posing as sloping, impact of anatomical variability on grading, inherent biases when grading stereoscopic images and absence of a control or glaucoma suspect group. Future research into this phenotype in POAG patients might determine whether sloping retina is the result of or a precursor to glaucomatous damage, leading to a better understanding of POAG.

A multi-cohort genome-wide association study in African ancestry individuals reveals risk loci for primary open-angle glaucoma

UNC Libraries · 2025-02-01

Choroidal evaluation of FTLD-Tau and biomarker-determined Alzheimer’s disease

Scientific Reports · 2025-07-01

Frontotemporal lobar degeneration with tauopathy (FTLD-Tau) can present clinically similar to Alzheimer's disease but lacks a biomarker. Alzheimer's disease has been associated with choroidal thinning compared to controls. We compared the choroid of 25 probable FTLD-Tau (pFTLD-Tau) patients (42 eyes), 26 biomarker-determined probable Alzheimer's disease neuropathologic change (pADNC) patients (49 eyes), and 53 normal controls (80 eyes). Cerebrospinal fluid biomarkers determined presence of ADNC. All pFTLD-Tau patients had a syndrome highly associated with FTLD-Tau. Optical coherence tomography was performed with masked manual choroidal thickness (CT) measurements. With Image J, binarized images determined the choroidal vascularity index (CVI). Linear regression with generalized estimating equations to account for inter-eye correlation was performed. For pFTLD-Tau, pADNC, and controls, the subfoveal CT was 308.9, 286.0, and 301.5 μm, and CVI was 0.72, 0.72, and 0.73, respectively (all p > 0.05 for each group comparison). Adjusting for demographics, the CT and CVI were not significantly different between groups, including 13 CT measurement locations (all p > 0.05). Among pADNC patients, an exploratory analysis found a correlation between CVI and disease duration (Pearson r = 0.32, p = 0.04). We found no significant difference of CT or CVI between pFTLD-Tau, pADNC, and controls. Additional studies are warranted to evaluate how CVI relates to ADNC.

A multi-cohort genome-wide association study in African ancestry individuals reveals risk loci for primary open-angle glaucoma

Cell · 2024 · 62 citations

• Biology
• Genetics
• Evolutionary biology

The HIV Services’ Milestone in Niger State: The Perception of the Frontline Providers

International Journal of Infectious Diseases and Therapy · 2024-04-02

Introduction: On 1&amp;lt;sup&amp;gt;st&amp;lt;/sup&amp;gt; December 2021, the Director General WHO during the world AIDS’s day opening remark stated that, “the global HIV epidemic has fainted from the headlines, but it is not over, far from it”. Nigerian is among the countries that have the highest HIV infection burden, and more HIV babies than anywhere in the world. Objective: The study was embarked upon to understand the perception of the HIV service providers who are in the frontline, on the difficulties being encountered in the course of duty. Method: Qualitative Data was obtained from selected HIV service providers, who were rich in experience across the state, through in-depth interviews (IDI), focus group discussions (FGD), and a non-participant observation with checklist. Saturation was reached, coding was done manually and automatic with NVivo 14, and thematic analytic method used to get a good induction from the data. Results: Among the difficulties being encountered by the HIV service providers from the study were burnt out, staff shortage, training deficiency, secondary stigmatization, and poor remuneration; similarly, lack of incentives, inability to follow-up, language, and religion barriers. Insecurity, the diminished awareness on HIV prevention, frequent change of implementing partners and lack of political will by policy makers were other identified challenges of the HIV services in the state. Conclusion: All relevant stakeholders need to work together towards reducing the difficulties highlighted by the providers toward the HIV eradication strategy. Government should take full possession and ownership of HIV management in Niger state, and the country.

Optic cup morphology associated with glaucomatous damage: Findings from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) Study

AJO International · 2024-07-14 · 3 citations

While it has been well established that advanced glaucoma is associated with a large cup-to-disc ratio (CDR), it is not known if the shape of the cup, particularly excavated cups with expanded lower portions (bean-pot cups), play any additional role in glaucomatous damage. We investigated this among individuals of African ancestry, a population that is more vulnerable to glaucoma than any other ethnic group. Case-control study Institutional (University of Pennsylvania) 3,255 eyes from 1,734 glaucoma cases from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Two graders independently assessed quantitative and qualitative aspects of the optic cup, with any discrepancies adjudicated by an ophthalmologist. The predominant cup shape (>50 %) was chosen in cases in which features of two or more cup shapes were present in the same eye. Comparisons of demographic and ocular characteristics among three cup shape groups (conical, cylindrical, and bean-pot) performed using generalized linear models, and generalized estimated equations applied to account for inter-eye correlation. Qualitative features of cup shape and phenotypic traits, in conjunction with demographic and genetic information. Of 3,255 eyes, a total of 1,339 (41.1 %) exhibit a conical cup shape, 1,470 (45.2 %) have a cylindrical cup shape, and 446 (13.7 %) display a bean-pot cup shape. Compared to other cup morphology, bean-pot cups are significantly associated with lower MD, larger CDR, higher IOP, thinner RNFL, and worse VA in logMAR (all p < 0.001). Genetic analysis does not show any association between various genetic variants and cup shape. Factors independently predictive of bean-pot cupping include younger age at diagnosis (aOR 0.96 per 1 year increase in age of enrollment, p < 0.0001), CDR (adjusted odds ratio (aOR) 1.87, p < 0.0001), and the presence of certain optic disc features, including visible pores in the LC (aOR 2.76, p < 0.0001), nasalization of vessels (aOR 2.64, p < 0.0001), and vessel bayonetting (aOR 2.94, p < 0.0001). This study shows the clinical significance of different cup shapes in glaucoma in an African ancestry population and suggests that bean-pot cups are associated with the most severe glaucomatous damage, independent of cup-disc ratio. This association should be considered when determining prognosis following glaucoma interventions.

Determinants of Risk Factors Associated with Low Birth Weight in Nigeria

American Journal of Nursing and Health Sciences · 2024-08-30 · 2 citations

Low birth weight (LBW) remains a significant public health challenge with profound implications for neonatal and child health, particularly in low-income countries. Defined by the World Health Organization as a birth weight of less than 2.5 kilograms, LBW contributes to increased neonatal mortality and long-term developmental issues. This study examines the prevalence and determinants of LBW in Nigeria, leveraging data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study employs a cross-sectional design and a stratified two-stage sampling technique, analyzing 7,728 recorded birth weights. Key findings indicate that maternal age, education, and socio-economic status significantly influence birth weight. Optimal reproductive ages (25-34 years) and higher educational attainment are associated with healthier birth weights, whereas younger (below 20 years) and older mothers (above 40 years), and those with lower education levels, face higher LBW risks. Employment and wealth are positively correlated with better birth outcomes, underscoring the importance of financial stability. Environmental factors such as urban residence, access to improved water sources, and sanitation facilities also play crucial roles in determining birth weight. The study compares frequentist logistic regression and Bayesian structured additive logistic regression models to identify and predict LBW risk factors, highlighting regional disparities within Nigeria. The findings emphasize the need for targeted interventions addressing socio-demographic, socio-economic, and environmental determinants to reduce the prevalence of LBW and improve maternal and child health outcomes. Enhanced understanding of these factors through advanced statistical modeling can inform policy and health interventions, ultimately contributing to achieving global health targets and improving neonatal health in Nigeria.

Features Associated with Visible Lamina Cribrosa Pores in Individuals of African Ancestry with Glaucoma: Primary Open-Angle African Ancestry Glaucoma Genetics (POAAGG) Study

Vision · 2024-04-18 · 2 citations

There are scarce data regarding the rate of the occurrence of primary open-angle glaucoma (POAG) and visible lamina cribrosa pores (LCPs) in the eyes of individuals with African ancestry; the potential impact of these features on disease burden remains unknown. We recruited subjects with POAG to the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Through regression models, we evaluated the association between the presence of LCPs and various phenotypic features. In a multivariable analysis of 1187 glaucomatous eyes, LCPs were found to be more likely to be present in eyes with cup-to-disc ratios (CDR) of ≥0.9 (adjusted risk ratio (aRR) 1.11, 95%CI: 1.04–1.19, p = 0.005), eyes with cylindrical-shaped (aRR 1.22, 95%CI: 1.11–1.33) and bean pot (aRR 1.24, 95%CI: 1.13–1.36) cups versus conical cups (p &lt; 0.0001), moderate cup depth (aRR 1.24, 95%CI: 1.06–1.46) and deep cups (aRR 1.27, 95%CI: 1.07–1.50) compared to shallow cups (p = 0.01), and the nasalization of central retinal vessels (aRR 1.33, 95%CI: 1.23–1.44), p &lt; 0.0001). Eyes with LCPs were more likely to have a higher degree of African ancestry (q0), determined by means of SNP analysis (aRR 0.96, 95%CI: 0.93–0.99, p = 0.005 for per 0.1 increase in q0). Our large cohort of POAG cases of people with African ancestry showed that LCPs may be an important risk factor in identifying severe disease, potentially warranting closer monitoring by physicians.