April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Baseline Risk Factors for Event and Trend-based Visual Field Glaucoma Progression using Fourier-Domain Optical Coherence Tomography in the Advance Imaging for Glaucoma Study
Author Affiliations & Notes
  • Xinbo Zhang
    Ophthalmology, Oregon Health & Science University, Portland, OR
  • Mitra Sehi
    Ophthalmology, University of Miami, Miami, FL
  • Ou Tan
    Ophthalmology, Oregon Health & Science University, Portland, OR
  • Rohit Varma
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
  • David S Greenfield
    Ophthalmology, University of Miami, Miami, FL
  • Joel S Schuman
    Ophthalmology, University of Pittsburgh, Pittsburgh, PA
  • Nils A Loewen
    Ophthalmology, University of Pittsburgh, Pittsburgh, PA
  • Brian A Francis
    Ophthalmology, University of Southern California, Los Angeles, CA
  • David Huang
    Ophthalmology, Oregon Health & Science University, Portland, OR
  • Footnotes
    Commercial Relationships Xinbo Zhang, None; Mitra Sehi, None; Ou Tan, OptoVue (P); Rohit Varma, Heidelberg Engineering (R), Carl Zeiss Meditech (F), Optovue (R); David Greenfield, Heidelberg Engineering (F), Carl Zeiss Meditech (F), Optovue (F); Joel Schuman, Carl Zeiss Meditech (P); Nils Loewen, None; Brian Francis, None; David Huang, Carl Zeiss Meditech (P), OptoVue (I)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 978. doi:
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    • Get Citation

      Xinbo Zhang, Mitra Sehi, Ou Tan, Rohit Varma, David S Greenfield, Joel S Schuman, Nils A Loewen, Brian A Francis, David Huang, ; Baseline Risk Factors for Event and Trend-based Visual Field Glaucoma Progression using Fourier-Domain Optical Coherence Tomography in the Advance Imaging for Glaucoma Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):978.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To determine whether optical coherence tomography anatomic measurements are useful in predicting the development of glaucomatous visual field progression.

Methods: We analyzed the data from perimetric glaucoma (PG) patients enrolled in the multi-center longitudinal Advanced Imaging for Glaucoma Study. Fourier-domain optical coherence tomography (FD-OCT) was used to measure disc variables and thickness profiles of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC). Standard automated perimetry was used to assess visual field. Subjects were followed every 6 months. Event-based visual field (VF) glaucoma progression was defined as significant worsening of ≥ 3 test locations on pattern deviation plot (three completely filled black triangles) repeated on three consecutive follow-up VF’s by Humphrey Glaucoma Progression Analysis software. The trend-based VF progression was defined as significant negative VFI slope shown in the Guided Progression Analysis software. Endpoint was reached when either type of progression was observed. Cox proportional hazard model was used to calculate the hazard ratios (HR) of the baseline risk factors. A multivariate model was fitted for each of the parameters with baseline pattern standard deviation (PSD); correlation from eyes of the same subjects was accounted for.

Results: The analysis included 302 eyes (204 participants) with average age of 61.8 years, among which 123 (60%) are female and 21 (10%) are African Americans. Average PSD at baseline was 5.7 while Average mean deviation (MD) was -4.8. Average follow-up time was 51 months. In the cohort, 48 eyes had event-based progression, 64 had trend-based progression and 29 had both. The most significant risk factors for VF progression was the GCC focal loss volume (FLV) (HR = 1.09, per 1% higher, p =0.0003). Other independent risks included baseline GCC global loss volume (GLV) (HR = 1.03, per 1% higher, p =0.03) and central corneal thickness (HR = 1.15 per 20 μm thinner, p = 0.016). None of the disc variables was a significant risk factor.

Conclusions: Glaucoma patients with higher baseline GCC FLV/GLV are more likely to have worsening of visual field defects, even after controlling for disease severity (VF PSD) in multivariate analysis, thus providing glaucoma patients in care with a better prediction for progression.

Keywords: 464 clinical (human) or epidemiologic studies: risk factor assessment • 758 visual fields • 531 ganglion cells  
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