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Abstract #90578 Published in IGR 21-3

Determination of retinal nerve fibre layer and ganglion cell/inner plexiform layers progression rates using two optical coherence tomography systems: The PROGRESSA study

Saks D; Schulz A; Craig J; Graham S;
Clinical and Experimental Ophthalmology 2020; 48: 915-926

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IMPORTANCE: Glaucoma progression rates may differ depending on the retinal structural parameters measured, and between devices. BACKGROUND: To compare retinal nerve fibre layer (RNFL) and ganglion cell/inner plexiform layers (GCL/IPL) progression rates using two spectral-domain optical coherence tomography (OCT) systems. DESIGN: Prospective, university hospital setting. PARTICIPANTS: Cross-sectional study: 100 eyes from 53 glaucoma suspects and early manifest glaucoma cases. Longitudinal study: subset of 61 eyes from 33 participants. METHODS: Same day optic nerve and macular images were acquired using Cirrus and Spectralis systems from which RNFL and GCL/IPL thicknesses were calculated. Longitudinal analysis of RNFL and GCL/IPL progression rates was calculated from 6 × 6-monthly follow-up OCT scans. MAIN OUTCOME MEASURES: RNFL and GCL/IPL thicknesses in matched superior, inferior and global regions were compared by both systems cross-sectionally and longitudinally. RESULTS: At baseline, no RNFL thicknesses differed between devices. Cirrus GCL/IPL regions were significantly thicker than Spectralis (P < .001). RNFL and GCL/IPL global progression rates (μm/y) had a mean (SD) of -1.28 (1.11) and 95% CI: (-1.48, -1.09) and -0.51 (0.58) and 95% CI: (-0.62, -0.41), respectively. Progression rates were similar across devices. RNFL loss (%) progressed significantly faster than GCL/IPL, in all regions (P ≤ .004). CONCLUSION AND RELEVANCE: Despite baseline thickness differences, overall Cirrus and Spectralis provided similar rates of RNFL and GCL/IPL progression in early glaucoma and can be considered comparable, though not interchangeable, in clinical practice. Further analysis is needed to determine if RNFL progresses faster than GCL/IPL in glaucoma, and whether one precedes the other.

Department of Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia.

Full article

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Classification:

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)

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