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Maria de los Angeles Ramos Cadena, Gadi Wollstein, Katie A. Lucy, Mengling Liu, Hiroshi Ishikawa, Joel S Schuman; Agreement Between Macula and Retinal Nerve Fiber Layer Guided Progression Analysis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):708.
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© ARVO (1962-2015); The Authors (2016-present)
Guided progression analysis (GPA) is a commonly used glaucoma progression detection method based on optical coherence tomography (OCT) that measures retinal nerve fiber layer (RNFL) thickness obtained with Cirrus HD-OCT. Recently, GPA based on ganglion cell inner plexiform layer (GCIPL) was introduced. The purpose of this study was to assess the agreement in progression detection between GPA using RNFL and GCIPL measurements.
118 open angle glaucoma eyes (78 subjects), 50 glaucoma suspects eyes (28 subjects), and 4 healthy eyes (2 subjects) that had comprehensive ophthalmic examination and greater than or equal to 5 visits with qualified OCT scans of the macula and optic nerve head regions were enrolled. GPA was used in all eyes with matching dates for baseline and final visits for RNFL and GCIPL analysis. Considering that trend analyses for both regions was previously reported, we focused on the event analysis where “probable event” of progression was defined as the first test showing progression and “likely event” as the one that immediately followed the probable event also showing progression. Stuart-Maxwell test was used for assessing agreement in the categorical analysis of progression.
Mean subject age was 68.5 ± 10.2 years and median baseline visual field mean deviation was -1.5dB ([Q1, Q3]; -4.32, -0.13). The majority of the eyes did not progress, but progression agreement between average RNFL and GCIPL and for superior RNFL and GCIPL showed statistically significant differences (P=0.017 and P<0.001, respectively; Table 1). No difference was detected in agreement for progression between inferior RNFL and GCIPL (P=0.389).
Superior and inferior RNFL and GCIPL GPAs showed limited agreement in detecting progression. Further investigation is required to identify the factors affecting this disparity.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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