June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Glaucoma structure-function modeling improves by combining retinal nerve fiber layer thickness (RNFLT) with neuro-retinal rim thickness (NRRT) measurements
Author Affiliations & Notes
  • Hui Wang
    Institute for Psychology and Behavior,Jilin University of Finance and Economics, Changchun, Jilin, China
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, United States
  • Neda Baniasadi
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, United States
    University of Massachusetts, Lowell, Massachusetts, United States
  • Qingying Jin
    Jilin University, Changchun, Jilin, China
  • Mengyu Wang
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, United States
  • Lucy Q Shen
    Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Louis R Pasquale
    Mass. Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Tobias Elze
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Hui Wang, None; Neda Baniasadi, None; Qingying Jin, None; Mengyu Wang, None; Lucy Shen, None; Louis Pasquale, None; Tobias Elze, PCT/US2014/052414 (P)
  • Footnotes
    Support   Harvard Glaucoma Center of Excellence; Lions Foundation; Grimshaw-Gudewicz Foundation; China Scholarship Council NO.201408220092; Education Department of Jilin Province[2015]No.335
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5813. doi:
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    • Get Citation

      Hui Wang, Neda Baniasadi, Qingying Jin, Mengyu Wang, Lucy Q Shen, Louis R Pasquale, Tobias Elze; Glaucoma structure-function modeling improves by combining retinal nerve fiber layer thickness (RNFLT) with neuro-retinal rim thickness (NRRT) measurements. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5813.

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

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Abstract

Purpose : To quantitatively compare sector-specific glaucoma structure-function models using RNFLT circle sectors around the optic nerve head (ONH) with models using thickness measured directly at the ONH border (NRRT).

Methods : From a large clinical glaucoma practice, circumpapillary optical coherence tomography (OCT) RNFLT scans around ONH and accompanying SITA Standard 24--2 Humphrey VFs (Cirrus HD OCT/Humphrey Field Analyzer, Carl Zeiss Meditec, Jena, Germany) were selected if the following reliability criteria were fulfilled: signal strength >= 6, no missing RFNLT data within the Cirrus standard circle (1.73 mm radius around ONH), no eye movement artifacts detected by a trained observer (OCT); false positive/negative rates <=20%, fixation loss rate <=33% (VF). One reliable pair of OCT/VF measurements of one randomly chosen eye per patient was selected. RNFLT on standard circle and NRRT, measured between Bruch's membrane opening and a machine-defined landmark on internal limiting membrane (Fig. 1a), were transferred from the Cirrus machine. VF and RNFLT/NRRT were partitioned into sectors according to the Garway-Heath map [1] (Fig. 1b). For each sector, linear regression models of VF mean total deviation (TD) were compared with RNFLT, NRRT, or both combined as regressors. A sector-specific Bayesian model comparison with Bayes Factor (BF) as selection criterion was calculated.

Results : 445 eyes of 445 patients met the selection criteria (age [mean±std. dev.]: 58.9±13.0 years, MD: -3.0±4.3 dB). RNFLT and NRRT were significantly (p<0.01) correlated to TD for all sectors (Fig. 1c). In the sector-specific RNFLT/NRRT model comparison (Fig. 2a), NRRT outperformed RNFLT for the central VF sector (BF=442) and RNFLT outperformed NRRT in all other sectors (BF between 8.9 and 1.3e+19). For all sectors, the combination of RNFLT and NRRT outperformed the respective best single parameter with positive evidence for the inner/temporal and very strong evidence for the nasal/peripheral VF sectors (Fig. 2b; BF between 4.8 and 886).

Conclusions : A combination of RNFLT and NRRT improves glaucoma structure-function modeling, particularly in nasal/peripheral VF sectors. NRRT, which is available on the Cirrus printout, should be taken into consideration as well for the interpretation of VFs.

[1] Garway-Heath et al. Ophthalmology 107:1809-15, 2000

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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