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Invited Commentary
April 2018

Visual Field Progression Is More Complicated Than Meets the Eye

Author Affiliations
  • 1Department of Ophthalmology, Scheie Eye Institute, Penn Medicine, Philadelphia
  • 2Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 3Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
JAMA Ophthalmol. 2018;136(4):335-336. doi:10.1001/jamaophthalmol.2017.6852

In this issue of JAMA Ophthalmology, Gracitelli et al1 raise more questions than answers, a few of which this Editorial will highlight. To summarize, the authors examined the longitudinal differences in perimetric testing in ancestry groups and determined that patients of African ancestry showed greater variability in visual field testing than individuals of European ancestry. As the authors noted, this finding and its underlying mathematical modeling suggests that delayed detection of progression of visual impairment may occur in patients of African descent. This delay may contribute to greater visual impairment in these patients compared with members of other ethnicities. Although one may draw a direct line between the differences noted between these groups and the conclusions of the authors, missing details beneath the surface raise questions that should be considered before settling on those conclusions.