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Abstract #46822 Published in IGR 13-3
Detection of progressive retinal nerve fiber layer thicknessloss with optical coherence tomography using4 criteria for functional progression
Grewal DS; Sehi M; Paauw JD; Greenfield DSJournal of Glaucoma 2011;
PURPOSE: To compare the rates of retinal nerve fiber layer (RNFL) thickness loss using optical coherence tomography (OCT) in progressing versus nonprogressing eyes using 4 methods to define functional progression. METHODS: Normal and glaucomatous eyes with (greater-than or equal to)3 years of follow up were prospectively enrolled. Standard automated perimetry (Swedish Interactive Threshold Algorithm Standard 24-2) and OCT (Stratus OCT, Carl Zeiss Meditec, Dublin, CA) imaging were performed every 6 months in glaucomatous eyes. OCT imaging was performed annually in normal eyes. Functional progression was determined using early manifest glaucoma trial criterion, visual field index (VFI), Progressor software, and the 3-omitting method. RESULTS: Seventy-six eyes (46 glaucoma and 30 normal) of 38 patients were enrolled with a mean follow-up of 43.9(plus or minus)5.02 months (range: 36 to 48 mo). Eleven eyes progressed using Progressor criterion, 5 eyes using VFI, 2 eyes using the 3-omitting method, and 2 eyes using Early Manifest Glaucoma Trial criterion. The annual rate of average RNFL loss ((mu)m/y) was significantly greater (P<0.05) in progressing versus nonprogressing eyes using Progressor (-1.0(plus or minus)1.3 vs. 0.02(plus or minus)1.6), VFI (-2.1(plus or minus)1.1 vs. -0.002(plus or minus)1.4), and the 3-omitting method (-2.2(plus or minus)0.2 vs. -0.1(plus or minus)1.5). Mean rate ((mu)m/y) of average and superior RNFL thickness change was similar (P>0.05) in nonprogressing glaucomatous eyes compared with normal eyes. Using linear mixed-effect models, mean (P<0.001) and peak (P=0.01) intraocular pressure were significantly associated with rate of average RNFL atrophy in glaucomatous eyes. CONCLUSIONS: Despite differences in criteria used to judge functional progression, eyes with standard automated perimetry progression have significantly greater rates of RNFL loss measured using OCT compared with nonprogressing eyes.
D. S. Grewal.
Classification:
6.20 Progression (Part of: 6 Clinical examination methods)
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
