Evidence map›Paper›PMID 40789618›Full record

ArticleBMJ open ophthalmology2025

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

Isabel Di Rosa, Amy-Ann Edziah, Rebecca Salowe, Yineng Chen, Roy Lee, Yan Zhu, Prithvi S Sankar, Victoria Addis, Ebenezer Daniel, Gui-Shuang Ying and 1 more

Abstract read
In one paragraph

Article in BMJ open ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Isabel Di RosaCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Amy-Ann EdziahCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Rebecca SaloweCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Yineng ChenCenter for Preventive Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Roy LeeCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Yan ZhuCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Prithvi S SankarCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Victoria AddisCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ebenezer DanielCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Gui-Shuang YingCenter for Preventive Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-5752-1355
Joan M O'BrienCenter for Genetics of Complex Disease, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA Joan.Obrien@uphs.upenn.edu.ORCID 0000-0003-4109-2928

Funding

Scientific TransparencyP30EY001583 · NEI · UNIVERSITY OF PENNSYLVANIA · PI CLAIRE H MITCHELL · 1985 to 2026
$19.5M
Primary Open Angle African-American Glaucoma Genetics Study RenewalR01EY023557 · NEI · UNIVERSITY OF PENNSYLVANIA · PI O'BRIEN, JOAN M · 2014 to 2025
$18.1M
NEI NIH HHS P30 EY001583NEI NIH HHS R01 EY023557
6 · The paper itself

Abstract

objectiveTo 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.

resultsThe 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.

conclusionAssociated 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.

Indexed as

Black PeopleGlaucoma, Open-AngleOptic DiskRetinaAdultAgedFemaleHumansIntraocular PressureMaleMiddle AgedPrevalenceRisk FactorsTomography, Optical CoherenceVisual FieldsGlaucomaImagingRetina

Identifiers

PMID40789618
PMCPMC12336614

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.