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Naama Hammel, Akram Belghith, Felipe A Medeiros, Nadia Mendoza, yang qin, Zhiyong Yang, Robert N Weinreb, Linda M Zangwill; Diagnostic Innovations in Glaucoma Study (DIGS): Comparing the Rates of Peripapillary Retinal Nerve Fiber layer and Ganglion Cell-Inner Plexiform Layer Loss in Healthy and Glaucoma Eyes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4568.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the rates of retinal nerve fiber layer (RNFL) thickness and retinal ganglion cell - inner plexiform layer (GCIPL) thickness change over time in healthy and glaucoma eyes.
55 eyes of 28 healthy subjects and 170 eyes of 93 glaucoma subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were included. Peripapillary RNFL and macular GCIPL thicknesses were measured every 3 months using Cirrus HD-OCT. The rates of RNFL and GCIPL loss in healthy and glaucoma eyes were compared using mixed effects models.
Mean age was 47 years (range 22.5-66) for healthy subjects and 68 years (32-90) for glaucoma subjects. The median (inter-quartile range) follow-up time and mean (range) number of visits were 1.7 years (1.5-2.1) and 6.1 visits (3-10), and 3.2 years (2.0-3.6) and 7.5 visits (3-15) for healthy and glaucoma eyes, respectively.<br /> In healthy eyes, mean rates of average, superior and inferior RNFL thickness change were -0.625 µm/year, 0.021 µm/year and -0.864 µm/year, respectively; In glaucoma eyes, the rates of change were -0.813 µm/year, -0.748 µm/year and -1.122 µm/year, respectively.<br /> The mean rates of average, superior and inferior GCIPL thickness change in healthy eyes were 0.323 µm/year, 0.634 µm/year and 0.184 µm/year respectively; In glaucoma eyes, the rates of change were -0.273 µm/year, -0.269 µm/year and -0.256 µm/year, respectively.<br /> In healthy eyes, only the average RNFL thickness change was significantly different from zero. In glaucoma eyes, all RNFL slopes and the average GCIPL slope were significantly different from zero.<br /> Within the same eyes, the median rates of RNFL change tended to be faster than the rates of GCIPL change in healthy eyes. In glaucoma eyes, the median rates of RNFL loss were significantly faster than GCIPL loss.
In this cohort, the mean rate of RNFL and GCIPL change tended to be faster in glaucoma eyes than in healthy eyes. Further, the rate of RNFL thickness change was faster than GCIPL change for both healthy and glaucoma eyes. This suggests that guidelines for differentiating between RNFL and GCIPL change due to aging and glaucomatous progression needs to be developed to facilitate appropriate clinical management of glaucoma.
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