June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Ganglion cell and retinal nerve fiber layer thickness predict the development of visual field damage in glaucoma suspects
Author Affiliations & Notes
  • Zhiyong Yang
    Ophthalmology, University of California San Diego, San Diego, CA
  • Andrew J Tatham
    Ophthalmology, University of California San Diego, San Diego, CA
  • Naama Hammel
    Ophthalmology, University of California San Diego, San Diego, CA
  • Lucie Sharpsten
    Ophthalmology, University of California San Diego, San Diego, CA
  • Felipe A Medeiros
    Ophthalmology, University of California San Diego, San Diego, CA
  • Robert N Weinreb
    Ophthalmology, University of California San Diego, San Diego, CA
  • Christopher A Girkin
    Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • Jeffrey M Liebmann
    Ophthalmology, New York University School of Medicine, New York, NY
    Ophthalmology, Harkness Eye Institute, Columbia University Medical Center, New York, NY
  • Linda M Zangwill
    Ophthalmology, University of California San Diego, San Diego, CA
  • Footnotes
    Commercial Relationships Zhiyong Yang, None; Andrew Tatham, None; Naama Hammel, None; Lucie Sharpsten, None; Felipe Medeiros, Alcon (F), Alcon (R), Allergan (C), Allergan (F), Allergan (R), Bausch & Lomb (F), Carl Zeiss (C), Carl Zeiss (F), Carl Zeiss (R), Heidelberg Engineering (F), Merck (F), National Eye Institute at NIH (F), Novartis (C), Reichert (F), Reichert (R), Senisimed (F), Topcon (F); Robert Weinreb, Aerie (F), Alcon (C), Allergan (C), Amatek (C), Aquesys (C), Bausch & Lomb (C), Carl Zeiss (C), Carl Zeiss (F), Genentech (F), Heidelberg Engineering (F), Nidek (F), Novartis (F), Optovue (F), Topcon (C), Topcon (F), Valeant (C); Christopher Girkin, Carl Zeiss (F), EyeSight Foundation of Alabama (F), Heidelberg Engineering (F), National Eye Institute at NIH (F), Research to Prevent Blindness (F), SOLX (F); Jeffrey Liebmann, Alcon (C), Allergan (C), Allergan (F), Bausch & Lomb (C), Bausch & Lomb (F), Carl Zeiss (F), Diopysis (C), Diopysis (F), Heidelberg Engineering (C), Heidelberg Engineering (F), Merz Pharmaceuticals (C), Optovue (F), Quark Pharmaceuticals (F), Reichert (F), Sensimed (F), Topcon (F), Valeant Pharmaceuticals (C); Linda Zangwill, Carl Zeiss (F), Carl Zeiss Meditec (P), Heidelberg Engineering (F), Nidek (F), Optovue (F), Quark (F), Topcon (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2054. doi:
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    • Get Citation

      Zhiyong Yang, Andrew J Tatham, Naama Hammel, Lucie Sharpsten, Felipe A Medeiros, Robert N Weinreb, Christopher A Girkin, Jeffrey M Liebmann, Linda M Zangwill; Ganglion cell and retinal nerve fiber layer thickness predict the development of visual field damage in glaucoma suspects. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2054.

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

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Abstract

Purpose: To compare baseline macular ganglion cell plus inner plexiform layer (mGCIPL) thickness and circumpapillary retinal nerve fiber layer (cpRNFL) thickness as predictors of visual visual field loss in glaucoma suspects.

Methods: This is a prospective, observational cohort study. Glaucoma suspects were defined as having suspicious glaucomatous optic disc appearance or ocular hypertension (intraocular pressure, > 21 mmHg) without repeatable standard automated perimetry (SAP) at baseline, from Diagnostic Innovations in Glaucoma Study and African Descent and Glaucoma Evaluation Study.Baseline mGCIPL thickness was measured using Cirrus optical coherence tomography (OCT) and baseline cpRNFL thickness measured using Spectralis spectral domain OCT (SD-OCT). The association between baseline mGCIPL or cpRNFL thicknesses and the development of 3 consecutive visual field damage (VFD) was determined by Cox proportional hazard univariate and multivariate models.

Results: 106 subjects (149 eyes) met the eligibility criteria. The mean number of visits was 5.6 ± 1.9 visits over a mean follow-up time of 2.25 ± 0.62 years. 23 eyes (15.4%) eyes developed a repeatable VFD during follow-up. In multivariate models, thinner baseline average and sectoral mGCIPL and cpRNFL were associated with the development of visual field damage, with HRs (95%CI) per 10μm thinner ranging from 1.65 (1.09, 2.50) for minimum mGCIPL thickness to 2.82 (1.54, 5.17) for average mGCIPL thickness, and 1.68 (0.96, 2.94) for average cpRNFL thickness and 1.71 (1.15, 2.54) for temporal cpRNFL thickness. No significant differences were found between c-indices calculated for mGCPIL and cpRNFL multivariate models.

Conclusions: Thinner mGCIPL and cpRNFL measurements at baseline have similar predictive abilities for the development of repeatable VFD among glaucoma suspects. Our results suggest that baseline mGCIPL and cpRNFL thickness measurements are useful in identifying glaucoma suspects who are at higher risk for progression to visual field damage.

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