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Chen LIN, Marco Yu, Christopher Kai-Shun Leung; Trend-based Progression Analysis (TPA) on Macular Thickness Map to Detect Glaucoma Progression. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):589.
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© ARVO (1962-2015); The Authors (2016-present)
The macula has the highest density of retinal ganglion cells in the retina, representing a strategic location to monitor glaucoma progression. We evaluated the performance of TPA on the macular thickness maps generated by optical coherence tomography (OCT) for detection of glaucoma progression.
33 eyes of 18 glaucoma patients were followed at 4-month intervals for a mean of 7.1years (range: 6.7-7.4 years) for macular imaging with a spectral-domain OCT (Cirrus HD-OCT, Carl Zeiss Meditec). Visual field (VF) was performed in the same visits with Humphrey Field Analyzer (Carl Zeiss Meditec). The macular thickness data of serial macular thickness maps (each map contained 50x50 superpixel macular thickness measurements) were exported for TPA for each eye. VF progression was determined using the Early Manifest Glaucoma Trial criteria. Progressive RNFL thinning was examined with Guided Progression Analysis (GPA, Carl Zeiss Meditec).
A total of 726 OCT macular thickness maps were analyzed and each eye had an average of 22 maps (range: 20-23 visits) for TPA. 25 eyes (75.6%) showed progressive macular thinning by TPA, 9 eyes showed progressive RNFL thinning by GPA, and 6 eyes had VF progression. Among the 9 eyes with RNFL progression, 6 also had macular thinning detected by TPA and all had TPA changes evident prior to GPA changes. All eyes with VF progression had macular thinning detected by TPA. Fig.1 illustrates a glaucomatous eye with progressive macular thinning and RNFL thinning followed for ~85 months.
A significant proportion of glaucomatous eyes (75.6%) showed progressive macular thinning over a mean of 7-year follow-up. Although it remains to be investigated whether the macular thinning represents disease-related or age-related change, TPA on the macular thickness map can provide an informative approach to track the topology of macular thickness changes in glaucoma patients.
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