# African Descent and Glaucoma Evaluation (ADAGES) IV: Alterations of the lamina cribrosa in progression

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $634,258

## Abstract

Project Abstract
Overall Objective: This proposal is focused on morphological changes in the lamina cribrosa with glaucoma
onset and progression, and how those changes impact visual function, with a focus on racial disparities. This
project leverages on the longitudinal monitoring of a subset of glaucoma patients in the existing ADAGES
cohort of which 3.7 years(average) of enhanced depth imaging optical coherence tomography (EDIOCT) and
visual field standard perimetry (VF) is available. The overall objective of the ADAGES studies is to identify
what ocular, systemic and genetic factors account for the differences in the glaucoma prevalence, severity,
and rates of disease progression in individuals of African Descent (AD) compared to those of European
Descent (ED). The specific aims are: 1) To determine if the progressive changes in lamina cribrosa
observed longitudinally in glaucomatous ADAGES patients will be associated with greater VF progression in
a 8(at least) year of EDOCT and VF follow-up imaging, and if this association differs across race. 2) To
determine what baseline morphologic characteristics of the optic nerve head (ONH) are associated with
progression-dependent remodeling of the lamina cribrosa and ONH. 3) To determine if mechanical
compliance of the ONH as measured in-vivo and longitudinally is associated with remodeling of the lamina
cribrosa and progressive neural tissue (structure) and VF damage (function). Design: Participants are 148
AD and 144 ED individuals with glaucoma who have 3.7 years(average) of ONH EDIOCT imaging and VF
longitudinal data from the ADAGES cohort. Demographic variables, ophthalmological examination including
stereo-photographs, visual function with standard perimetry, intraocular and systemic pressures, and other
risk factors will be documented longitudinally. The morphology and compliance of the lamina cribrosa and
ONH will be quantified on 60 newly enrolled ED and 60 AD glaucoma patients by EDIOCT and VF imaging
over a follow-up of 5 or more years. Impact: Glaucoma is 4 to 5 times more likely to occur and progress to
severe visual impairment in persons of AD compared to persons of ED. Our group has identified several
racial differences in the morphology and mechanical behavior of the lamina cribrosa and peripapillary sclera
that suggest these differences will meaningfully impact or possibly be causative of the load bearing
connective tissue remodeling seen in both natural aging and in the onset and progression of glaucoma. The
race-specific and extensive longitudinal data of this study will provide a detailed insight of the
pathophysiologic relationship between remodeling of the ONH load bearing tissues with the rate of structural
damage of the retinal neural tissue and the resulting progressive visual impairment. This study, through the
inclusion of an innovative biomechanical compliance testing protocol, will inform the development of
mechanistically relevant biomarkers for glaucoma necessary for th...

## Key facts

- **NIH application ID:** 9903321
- **Project number:** 5R01EY026574-04
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Massimo Antonio Fazio
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $634,258
- **Award type:** 5
- **Project period:** 2017-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9903321

## Citation

> US National Institutes of Health, RePORTER application 9903321, African Descent and Glaucoma Evaluation (ADAGES) IV: Alterations of the lamina cribrosa in progression (5R01EY026574-04). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/9903321. Licensed CC0.

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