advertisement
Abstract #84526 Published in IGR 21-1
Ganglion Cell-Inner Plexiform Layer and Retinal Nerve Fiber Layer Changes in Glaucoma Suspects Enable Prediction of Glaucoma Development
Shin JW; Sung KR; Song MKAmerican Journal of Ophthalmology 2020; 210: 26-34
PURPOSE: To investigate whether progressive macular ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (RNFL) thinning predict development of visual field (VF) defects in glaucoma suspects. DESIGN: Retrospective cohort study. METHODS: This study included 541 eyes of 357 glaucoma suspects with a mean follow-up of 5.7 years. Progressive GCIPL and RNFL thinning were determined using Guided Progression Analysis (GPA) in optical coherence tomography (OCT). The development of VF defect was defined as the presence of three consecutive abnormal VFs. The risk of developing VF defect was evaluated using Cox proportional hazard models. RESULTS: A total of 74 eyes (13.7%) and 87 eyes (16.1%) showed progressive GCIPL and RNFL thinning by OCT GPA, respectively, and 40 eyes (7.4%) developed VF defects. Eyes with progressive GCIPL (hazard ratio [HR], 7.130; 95% confidence interval [CI], 3.137-16.205) and RNFL (HR, 7.525; 95% CI, 3.272-17.311) thinning showed a significantly higher risk of developing VF defects. The rate of change in the average GCIPL and RNFL thickness was significantly higher in the eyes that developed VF defects (-0.71 and -1.13 μm/y, respectively) than the eyes that did not (-0.19 and -0.27 μm/y, respectively; all P < 0.05). Progressive GCIPL (43.1 vs. 63.1 months, respectively; P < 0.001) and RNFL (50.9 vs. 66.7 months, respectively; P < 0.001) thinning were detected significantly earlier than the development of VF defects. CONCLUSIONS: Monitoring progressive change in GCIPL, as well as RNFL, effectively predicts the development of VF defects in glaucoma suspects.
Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea.
Full articleClassification:
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)
13.1 Prognostic factors (Part of: 13 Therapeutic prognosis and outcome)
