Abstract
Purpose
The objective of this study is to assess whether baseline optic nerve head (ONH) topography and retinal nerve fiber layer thickness (RNFLT) are predictive of glaucomatous visual-field progression in glaucoma suspect (GS) and glaucomatous eyes, and to calculate the level of risk associated with each of these parameters.
Methods
Participants with ≥28 months of follow-up were recruited from the longitudinal Advanced Imaging for Glaucoma Study. All eyes underwent standard automated perimetry (SAP), confocal scanning laser ophthalmoscopy (CSLO), time-domain optical coherence tomography (TDOCT), and scanning laser polarimetry using enhanced corneal compensation (SLPECC) every 6 months. Visual-field progression was assessed using pointwise linear-regression analysis of SAP sensitivity values (progressor) and defined as significant sensitivity loss of >1 dB/year at ≥2 adjacent test locations in the same hemifield at P<0.01. Cox proportional hazard ratios (HR) were calculated to determine the predictive ability of baseline ONH and RNFL parameters for SAP progression using univariate and multivariate models.
Results
Seventy-three eyes of 73 patients (43 GS and 30 glaucoma, mean age 63.2±9.5 years) were enrolled (mean follow-up 51.5±11.3 months). Four of 43 GS (9.3%) and 6 of 30 (20%) glaucomatous eyes demonstrated progression. Mean time to progression was 50.8±11.4 months. Using multivariate models, abnormal CSLO temporal-inferior Moorfields classification (HR=3.76, 95% confidence interval (CI): 1.02–6.80, P=0.04), SLPECC inferior RNFLT (per −1 μm, HR=1.38, 95% CI: 1.02–2.2, P=0.02), and TDOCT inferior RNFLT (per −1 μm, HR=1.11, 95% CI: 1.04–1.2, P=0.001) had significant HRs for SAP progression.
Conclusion
Abnormal baseline ONH topography and reduced inferior RNFL are predictive of SAP progression in GS and glaucomatous eyes.
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Acknowledgements
This study was supported by NIH Grant R01-EY013516, Bethesda, MD, USA; P30EY014801 University of Miami Core Grant; unrestricted grant from Research to Prevent Blindness, New York, NY, USA; and Department of Defense Grant to University of Miami (DOD-Grant number W81XWH-09-1-0675). Dr Greenfield has received research support from Carl Zeiss Meditec Inc.
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Presented in part at the Annual Meeting of American Glaucoma Society, Dana Port, CA, USA, on 5 March 2011
Appendix A
Appendix A
Advanced Imaging for Glaucoma (AIG) Study Group: (1) Bascom Palmer Eye Institute, University of Miami, Palm Beach Gardens, FL, USA: DS Greenfield, M Sehi, CD Quinn, K Kishor; (2) University of Pittsburgh Medical Center, Pittsburgh, PA, USA: JS Schuman, G Wollstein, H Ishikawa, RJ Noecker, Larry Kagemann; (3) Doheny Eye Institute, University of Southern California, Los Angeles, CA, USA: R Varma, V Chopra, B Francis; (4) Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA: D Huang, J Morrison, P Francis, B Edmunds, M Parikh, D Gatty, R Armour, L Lombardi, O Tan, Xinbo Zhang, Yimin Wang. See www.AIGStudy.net for the full list of authors.
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Sehi, M., Bhardwaj, N., Chung, Y. et al. Evaluation of baseline structural factors for predicting glaucomatous visual-field progression using optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy. Eye 26, 1527–1535 (2012). https://doi.org/10.1038/eye.2012.203
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DOI: https://doi.org/10.1038/eye.2012.203
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