June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes
Author Affiliations & Notes
  • Atsuya Miki
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Linda Zangwill
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Sonia Jain
    Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
  • Feng He
    Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
  • Naira Khachatryan
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Naama Hammel
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Jeffrey Liebmann
    Department of Ophthalmology, New York University School of Medicine, New York, NY
    Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Christopher Girkin
    Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • Felipe Medeiros
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Robert Weinreb
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Footnotes
    Commercial Relationships Atsuya Miki, NIDEK (C); Linda Zangwill, Carl Zeiss Meditec Inc (F), Heidelberg Engineering GmbH (F), Optovue Inc (F), Topcon Medical Systems Inc (F), Nidek Inc (F); Sonia Jain, None; Feng He, None; Naira Khachatryan, None; Naama Hammel, None; Jeffrey Liebmann, Alcon Laboratories, Inc. (C), Allergan, Inc. (C), Allergan, Inc. (F), Carl Zeiss Meditech, Inc (F), Heidelberg Engineering, GmbH (F), Topcon Medical Systems, Inc. (F), National Eye Institute (F), New York Glaucoma Research Institute (F), SOLX, Inc. (C), Bausch & Lomb, Inc (C), Diopsys, Inc. (C), Diopsys, Inc. (F), Merz, Inc. (C), Glaukos, Inc. (C), Quark, Inc. (C); Christopher Girkin, SOLX (F), Heidelberg Engineering (F); Felipe Medeiros, Carl-Zeiss (F), Heidelberg Engineering (F), Topcon (F), Alcon (F), Allergan (F), Sensimed (F), Reichert (F); Robert Weinreb, Aerie (F), Alcon (C), Allergan (C), Altheos (C), Amakem (C), Bausch&Lomb (C), Carl Zeiss-Meditec (C), Genentech (F), Haag-Streit (F), Heidelberg Engineering (F), Konan (F), Lumenis (F), National Eye Institute (F), Nidek (F), Optovue (C), Quark (C), Solx (C), Topcon (C)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1706. doi:
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    • Get Citation

      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)

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Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: 550 imaging/image analysis: clinical • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 610 nerve fiber layer  
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