September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Detecting Structural Change in Advanced Glaucoma Eyes
Author Affiliations & Notes
  • Linda M Zangwill
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, Univ of California-San Diego, La Jolla, California, United States
  • Felipe A Medeiros
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, Univ of California-San Diego, La Jolla, California, United States
  • Christopher Bowd
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, Univ of California-San Diego, La Jolla, California, United States
  • Christopher A Girkin
    School of Medicine, University of Alabama, Birmingham, Birmingham, Alabama, United States
  • Jeffrey M Liebmann
    Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • Robert N Weinreb
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, Univ of California-San Diego, La Jolla, California, United States
  • Akram Belghith
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, Univ of California-San Diego, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Linda Zangwill, Carl Zeiss Meditec (F), Heidelberg Engineering (F), Optovue (F), Quark (F), Topcon (F); Felipe Medeiros, Alcon (C), Allergan (F), Allergan (C), Ametek (F), Ametek (C), Bausch + Lomb (F), Carl Zeiss Meditec (F), Carl Zeiss Meditec (C), Heidelberg Engineering (F), Heidelberg Engineering (C), Sensimed (F), Topcon (F); Christopher Bowd, None; Christopher Girkin, Carl Zeiss Meditec (F), EyeSight Foundation of Alabama (F), Heidelberg Engineering (F), National Eye Institute (F), Research to Prevent Blindness (F), SOLX (F); Jeffrey Liebmann, Alcon (C), Allergan (C), Bausch + Lomb (C), Bausch + Lomb (F), Carl Zeiss Meditec (F), Carl Zeiss Meditec (C), Heidelberg Engineering (F), National Eye Institute (F), Optovue (F), Reichert (C), Reichert (F), Topcon (F), ValeantHeidelberg Engineering (C), Valeant Pharmaceuticals, Inc (C); Robert Weinreb, Alcon (C), Allergan (C), Bausch + Lomb (C), Carl Zeiss Meditec (C), Carl Zeiss Meditec (F), Genentech (F), Heidelberg Engineering (F), Optovue (F), Topcon (C), Topcon (F); Akram Belghith, None
  • Footnotes
    Support  NIH Grant EY11008; NIH Grant EY019869; NIH Grant, EY021818,NIH Grant EY022589; Unrestricted grant from Research to Prevent Blindness New York, NY; Participant retention incentive grants in the form of glaucoma medication at no cost from Alcon Laboratories, Allergan, Pfizer Inc, and Santen Inc.; Eyesight Foundation of Alabama; Edith C. Blum Research Fund of the New York Glaucoma Research Institute, New York, NY
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 838. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Linda M Zangwill, Felipe A Medeiros, Christopher Bowd, Christopher A Girkin, Jeffrey M Liebmann, Robert N Weinreb, Akram Belghith; Detecting Structural Change in Advanced Glaucoma Eyes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):838.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : To compare the longitudinal loss of minimum rim width (MRW), circumpapillary retinal fiber layer thickness (cpRNFL) and retinal ganglion cell – inner plexiform layer (GCIPL) measured by spectral domain optical coherence tomography (SD-OCT) in advanced glaucoma eyes and to compare the number of progressing glaucoma eyes using these measurements and a new three dimensional 3D optic nerve head (ONH) change detection method that does not require retinal layer segmentation.

Methods : A total of 35 eyes of 35 patients with advanced glaucoma (visual field (VF) mean deviation (MD) worse than -20 dB) from the African Descent and Glaucoma Evaluation Study (ADAGES) and the Diagnostic Innovations in Glaucoma Study (DIGS) were included. 46 eyes of 30 healthy subjects were used to estimate aging changes/specificity. All eyes underwent Spectralis SD-OCT imaging with the cpRNFL, MRW and GCIPL layer thicknesses measured using the San Diego automated layer segmentation algorithm (SALSA). Progression was defined when structural loss was significantly different from zero and faster than the 5st percentile of the healthy group. Progression rates were calculated using mixed effects models. The 3D glaucoma change detection was estimated using the Bayesian-kernel detection scheme (BKDS) (Belghith et al. Artif Intell Med. 2015).

Results : Mean age, visual field MD, years of follow-up and number of visits was 59 years (range 48-72), 0.2 dB, 2.8 years and 6 visits for healthy subjects and 77 years (range 69-92), -28 dB (range -33, -21 dB), 3.5 years and 5 visits for glaucoma subjects. In healthy eyes, mean rates (p-value) of RNFL, MRW and GCIPL change were -0.32 µm/yr (P<0.001), -1.41 µm/yr (P<0.001), and -0.11 µm/yr (P<0.001) respectively; In advanced glaucoma eyes, the rates of change were -0.08 µm/yr (P=0.39), -0.29 µm/yr (P=0.43), and -0.18 µm/yr (P=0.02) respectively. The number of progressing glaucoma eyes identified by cpRNFL, MRW, GCIPL and 13 and BKDS was 2, 4, 11, and 13, respectively. Among the 13 eyes detected by the BKDS, 7 eyes were also identified by GCIPL, 3 eyes by MRW and 1 by cpRNFL.

Conclusions : In these very advanced glaucoma eyes, in contrast to MRW and cpRNFL, mean GCIPL thickness showed a rate of change significantly different than zero. GCIPL and 3D BKDS method shows promise for identifying change in advanced glaucoma. These results suggest that even in very advanced disease, structural change can be detected using SDOCT imaging.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×