June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Determinants of inter-eye asymmetry in circumpapillary retinal nerve fiber layer (cpRNFL) thickness in healthy and glaucoma patients
Author Affiliations & Notes
  • Lynn Shi
    Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York, United States
    Psychology, Columbia University, New York, New York, United States
  • C Gustavo De Moraes
    Ophthalmology, Columbia University, New York, New York, United States
  • Denis Weng
    Psychology, Columbia University, New York, New York, United States
  • Rashmi Rajshekhar
    Psychology, Columbia University, New York, New York, United States
  • Robert Ritch
    Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
  • Donald Hood
    Psychology, Columbia University, New York, New York, United States
    Ophthalmology, Columbia University, New York, New York, United States
  • Footnotes
    Commercial Relationships   Lynn Shi, None; C Gustavo De Moraes, None; Denis Weng, None; Rashmi Rajshekhar, None; Robert Ritch, None; Donald Hood, Heidelberg Engineering (F), Heidelberg Engineering (R), Topcon Inc. (F), Topcon Inc. (R)
  • Footnotes
    Support  NEI RO1-EY-02115, NEI: EY025253, Stanley and Carol Levy Research Fund of the New York Glaucoma Research Institute
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3989. doi:
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      Lynn Shi, C Gustavo De Moraes, Denis Weng, Rashmi Rajshekhar, Robert Ritch, Donald Hood; Determinants of inter-eye asymmetry in circumpapillary retinal nerve fiber layer (cpRNFL) thickness in healthy and glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3989.

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

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Abstract

Purpose : To investigate the causes of inter-eye asymmetry in cpRNFL thickness in glaucoma patients and healthy controls.

Methods : Both eyes of 63 glaucoma patients and 33 healthy patients had swept-source OCT wide-field cube scans (9x12 mm, DRI-OCT, Topcon, Inc.). At least one eye of the glaucoma patients had a 24-2 mean deviation better than -6D. For each patient, the inter-eye variability (IEV) in cpRNFL was defined as IEV = 1/n Σ ni=1 (xi,a-xi,b)2, where n is the number of circumpapillary values, a and b are right and left eyes. IEV was calculated for the (i) global cpRNFL (GB), (ii) superior (SQ) and (iii) inferior (IQ) quadrants. For each, linear regression models with the following parameters were tested: intraocular pressure (IOP), central corneal thickness (CCT), the angle (DFA) and distance (DFD) between the optic disc center and the fovea, disc area (DA), and the angles between the optic disc center and the superior (SBV) and inferior blood vessels (IBV).

Results : On average, GB, SQ, and IQ IEV values of the 33 healthy patients (376±197, 296±219, 279±350) were smaller than that of the 63 glaucoma patients (932±672, 485±477, 1014±1087; all P<0.05). Among healthy patients, the 7 parameters explained 32%, 36%, and 32% of inter-eye asymmetry for GB, SQ, and IQ, respectively. For the healthy patients, the significant predictors were SBV and IBV for GB; IOP, SBV, and IBV for SQ; and only IBV for IQ. For the 17 (27%) of 63 glaucoma patients with unilateral disease, 3 had widespread and 14 had local loss. For the 46 (73%) patients with bilateral disease, a similar inter-eye pattern of damage was seen in 29 patients (Fig. 1), while 17 others had damage of different degrees (Fig. 2). The 7 parameters explained 10%, 11%, and 7% of inter-eye asymmetry for GB, SQ, and IQ, respectively. CCT was a significant predictor for SQ, while none of the tested parameters was a significant, independent predictor of inter-eye asymmetry for GB and IQ.

Conclusions : Qualitatively, eyes in patients tended to have damage in the same location. Quantitatively, for the healthy patients, blood vessel angles (SBV and IBV) played the largest role in inter-eye differences. In glaucoma patients, one healthy eye or different degrees of glaucomatous damage were major causes of inter-eye asymmetry in cpRNFL thickness.

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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