June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Rates of Retinal Nerve Fiber Layer Loss in the Contralateral Eyes of Glaucoma Patients Showing Unilateral Progression by Conventional Methods
Author Affiliations & Notes
  • Ting Liu
    Department of Ophthalmology, UCSD, Hamilton Glaucoma Center, San Diego, CA
    Ophthalmology, Daping Hospital, Chongqing, China
  • Andrew J Tatham
    Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, Edinburgh, United Kingdom
  • Carolina Gracitelli
    Department of Ophthalmology, UCSD, Hamilton Glaucoma Center, San Diego, CA
    Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
  • Linda M Zangwill
    Department of Ophthalmology, UCSD, Hamilton Glaucoma Center, San Diego, CA
  • Lixian Chen
    Department of Ophthalmology, UCSD, Hamilton Glaucoma Center, San Diego, CA
  • Robert N Weinreb
    Department of Ophthalmology, UCSD, Hamilton Glaucoma Center, San Diego, CA
  • Felipe A Medeiros
    Department of Ophthalmology, UCSD, Hamilton Glaucoma Center, San Diego, CA
  • Footnotes
    Commercial Relationships Ting Liu, None; Andrew Tatham, Heidelberg Engineering Inc. (C); Carolina Gracitelli, None; Linda Zangwill, Carl Zeiss Meditec Inc (F), Carl Zeiss Meditec Inc (P), Heidelberg Engineering GmbH (F), Nidek Inc (F), Quark (F), Topcon Medical Systems Inc (F); Lixian Chen, None; Robert Weinreb, Aerie (F), Alcon (C), Allergan (C), Amatek (C), Aquesys (C), Bausch&Lomb (C), Carl Zeiss Meditec (C), Carl Zeiss Meditec Inc (F), Genentech (F), Heidelberg Engineering Inc (F), Nidek Inc (F), Novartis (F), Optovue (F), Topcon (C), Topcon (F), Valeant (C); Felipe Medeiros, Alcon Laboratories Inc (F), Alcon Laboratories Inc (R), Allergan Inc (F), Allergan Inc (R), Allergan, Inc (C), Bausch & Lomb (F), Carl Zeiss Meditec Inc (F), Carl Zeiss Meditec Inc (R), Carl-Zeiss Meditec, Inc (C), Heidelberg Engineering Inc (F), Merck Inc. (F), National Eye Institute (F), Novartis (C), Reichert Inc (R), Reichert, Inc (F), Sensimed (F), Topcon Inc (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2055. doi:
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      Ting Liu, Andrew J Tatham, Carolina Gracitelli, Linda M Zangwill, Lixian Chen, Robert N Weinreb, Felipe A Medeiros; Rates of Retinal Nerve Fiber Layer Loss in the Contralateral Eyes of Glaucoma Patients Showing Unilateral Progression by Conventional Methods. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2055.

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

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Abstract

Purpose: To determine whether progressive retinal nerve fiber layer (RNFL) loss occurs in the contralateral eye of patients with glaucoma showing unilateral progression according to conventional diagnostic methods.

Methods: This was an observational cohort study involving 346 eyes of 173 patients (118 eyes with glaucoma and 228 eyes with suspected glaucoma at baseline) recruited from the Diagnostic Innovations Glaucoma Study (DIGS). Average follow-up time was 3.5 ± 0.7 years. All subjects had standard automated perimetry (SAP, HFA) and spectral- domain optical coherence tomography (SD-OCT; Heidelberg Engineering, Heidelberg, Germany) in both eyes at 6-month intervals, with a minimum of 5 SAP and 5 SD-OCT examinations in each eye. Eyes were determined as progressing by conventional methods if there was progression on masked grading of optic disc stereophotographs or SAP guided progression analysis (GPA, “likely progression”). Rates of change in SD-OCT average RNFL thickness were obtained by linear mixed effects model.

Results: 39 subjects had evidence of unilateral progression by GPA and/or disc photographs during follow-up. Mean ± SE rate of RNFL loss in eyes progressing by conventional methods was −0.89 ± 0.22 μm/year; P < 0.001. The contralateral eyes of these subjects also showed significant loss of RNFL over time (−1.00 ± 0.20 μm/year; P < 0.001). 134 subjects did not show progression by conventional methods in either eye. These eyes also had significant decline over time in average RNFL thickness (−0.71 ± 0.09 μm/year; P < 0.001), however, the rate of change in these eyes was slower than the contralateral eye of patients showing unilateral progression (P < 0.001).

Conclusions: Significant RNFL thickness loss was seen in the contralateral eyes of glaucoma patients showing unilateral progression by conventional methods. These findings indicate that assessment of RNFL thickness by SD-OCT may show progressive glaucomatous damage that is not detected by visual fields or optic disc stereophotography.

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