June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Detecting Glaucomatous Structural Changes in Glaucoma Suspect Eyes Using a Cohort of Stable Glaucoma Patients
Naama Hammel; Linda Zangwill; Atsuya Miki; Sonia Jain; Feng He; Naira Khachatryan; Jeffrey Liebmann; Christopher Girkin; Felipe Medeiros; Robert Weinreb
Author Affiliations & Notes
  • Naama Hammel
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Linda Zangwill
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Atsuya Miki
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Sonia Jain
    Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
  • Feng He
    Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
  • Naira Khachatryan
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Jeffrey Liebmann
    New York University School of Medicine, New York, NY
    Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Christopher Girkin
    School of Medicine, University of Alabama, Birmingham, AL
  • Felipe Medeiros
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Robert Weinreb
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, CA
  • Footnotes
    Commercial Relationships Naama Hammel, None; Linda Zangwill, Carl Zeiss Meditec Inc (F), Heidelberg Engineering GmbH (F), Optovue Inc (F), Topcon Medical Systems Inc (F), Nidek Inc (F); Atsuya Miki, NIDEK (C); Sonia Jain, None; Feng He, None; Naira Khachatryan, None; Jeffrey Liebmann, Alcon Laboratories, Inc. (C), Allergan, Inc. (C), Allergan, Inc. (F), Carl Zeiss Meditech, Inc (F), Heidelberg Engineering, GmbH (F), Topcon Medical Systems, Inc. (F), National Eye Institute (F), New York Glaucoma Research Institute (F), SOLX, Inc. (C), Bausch & Lomb, Inc (C), Diopsys, Inc. (C), Diopsys, Inc. (F), Merz, Inc. (C), Glaukos, Inc. (C), Quark, Inc. (C); Christopher Girkin, SOLX (F), Heidelberg Engineering (F); Felipe Medeiros, Carl-Zeiss (F), Heidelberg Engineering (F), Topcon (F), Alcon (F), Allergan (F), Sensimed (F), Reichert (F); Robert Weinreb, Aerie (F), Alcon (C), Allergan (C), Altheos (C), Amakem (C), Bausch&Lomb (C), Carl Zeiss-Meditec (C), Genentech (F), Haag-Streit (F), Heidelberg Engineering (F), Konan (F), Lumenis (F), National Eye Institute (F), Nidek (F), Optovue (C), Quark (C), Solx (C), Topcon (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4802. doi:
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      Naama Hammel, Linda Zangwill, Atsuya Miki, Sonia Jain, Feng He, Naira Khachatryan, Jeffrey Liebmann, Christopher Girkin, Felipe Medeiros, Robert Weinreb; Detecting Glaucomatous Structural Changes in Glaucoma Suspect Eyes Using a Cohort of Stable Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4802.

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Abstract

Purpose: To establish normative test-retest variability limits for Spectralis SD-OCT retinal nerve fiber layer thickness (RNFLT) measurements using a cohort of stable glaucoma patients, and to evaluate whether changes exceeding these limits are associated with the development of glaucomatous visual field damage in a group of glaucoma suspects.

Methods: In order to estimate the 95 and 99 percentile variability limits, a group of stable glaucoma patients with repeatable visual field damage underwent weekly Spectralis SD-OCT testing over a period of approximately 5 weeks. Fifty-five eyes of 29 stable glaucoma patients were included to compute the “95%change” and “99%change” (progression, improvement or both) criteria. Glaucoma suspects, defined as subjects having glaucomatous optic neuropathy based on stereo-photograph review or ocular hypertension without repeatable visual field damage at baseline, and ≥3 Spectralis SD-OCT visits were included. Eyes were classified as converts or non-converts based on the development of repeatable (3x) visual field damage. Glaucoma Suspect eyes were classified as having a repeatable RNFLT change if ≥2 visits change exceeded the 95% and/or 99% change cut-offs; otherwise eyes were considered as not changing.

Results: 474 eyes of 312 glaucoma suspects included had a median of 4 SD-OCT visits (range 3 to 11) over a median of 2.3 years. Seventy-nine eyes (16.6%) were classified as converts and 395 eyes (83.4%) were classified as non-converts. Of the 90 patients who met 99% progression criteria for global RNFLT 22 (27.85%) were converts and 68 (75.56%) non-converts. Of the 21 patients who met the 99% progression criteria for RNFLT Superior 4 (19%) were converts and 17 (81%) non-converts. Of the 81 patients who met the 99% progression criteria for RNFLT Inferior 15 (18.52%) were converts and 66 (81.48%) non-converts. Significant associations were observed between visual field conversion and global RNFL thinning exceeding the 95% and 99% cut-offs (odds ratios= 1.69 (95% CI 1.006, 2.84) and 1.84 (95% CI 1.05, 3.22) respectively). There were no significant associations between VF conversion and sectoral RNFL thinning.

Conclusions: The development of visual field damage was associated with global RNFL thinning established using limits derived from SD-OCT testing of stable glaucoma eyes.

Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 550 imaging/image analysis: clinical • 610 nerve fiber layer  
© 2013, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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