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Atsuya Miki, Linda Zangwill, Sonia Jain, Feng He, Naira Khachatryan, Naama Hammel, Jeffrey Liebmann, Christopher Girkin, Felipe Medeiros, Robert Weinreb; Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1706.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the relationship between the rates of change in retinal nerve fiber layer thickness (RNFLT) as measured with Spectralis spectral-domain optical coherence tomography (SD-OCT) and the development of visual field defect (convert) in glaucoma suspect eyes.
Glaucoma suspects, defined as having glaucomatous optic neuropathy based on stereophotograph review or ocular hypertension (OHT; IOP >21 mm Hg) at baseline without a history of repeatable glaucomatous visual field damage from the Diagnostic Innovations in Glaucoma Study, and the African Descent and Glaucoma Evaluation Study were included. Global and sectoral (temporal, superior-temporal, inferior-temporal, nasal, superior-nasal, inferior-nasal, superior, inferior) RNFLT were measured with the Spectralis SD-OCT. Eyes were classified as converts or nonconverts based on the development of repeatable visual field damage. Linear mixed-effects models were used to evaluate rates of change in RNFLT and their relationship with the development of visual field defect.
Five hundred and fifty two eyes of 361 glaucoma suspects were included. 121 subjects (33.5%) were of African Descent (AD) and 240 subjects (66.5%) were of European Descent (ED). 276 eyes (50%) were categorized as OHT at the baseline examination. Mean age ± SD at baseline was 64.4 ± 11.6 years. The average number of OCT examinations per eye was 4.1 (range, 2-11). One hundred and two eyes (18.5%) were classified as converts and 450 eyes were classified as non-converts. Median follow-up time was 2.18 years. Rates of change in RNFLT were significantly faster in converts compared to non-converts in global (-1.16 μm/year vs. -0.69 μm/year, P=0.007), superior-temporal (-1.37 μm/year vs. -0.44 μm/year, P=0.012), superior (-1.03 μm/year vs. -0.34 μm/year, P=0.024), and inferior (-1.84 μm/year vs. -1.19μm/year, P=0.027) sectors. No significant difference in the rate of RNFL loss between converts and non-converts was found in the temporal and nasal sectors.
Even with a relatively short follow-up, the rate of RNFL loss measured with SD-OCT was in some sectors, 3 times faster in visual field converts compared to non-converts. Results of this study suggest that measuring the rate of SD-OCT RNFL loss may be a useful tool to help identify patients that develop visual field damage.
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