Purchase this article with an account.
Julia M. Wessel, Folkert K. Horn, Ralf P. Tornow, Friedrich E. Kruse, Christian Y. Mardin, Robert Lämmer; Analysis Of Progression In Glaucoma Using Spectral-domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2012;53(14):232.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To examine whether loss of retinal nerve fiber layer (RNFL) thickness measured by spectral-domain optical coherence tomography is correlated with progression of optic disc damage in glaucoma.
38 eyes from 38 patients (members of the Erlangen Glaucoma Registry, NTC00494923) with open angle glaucoma were included in the study. All patients received a detailed standardized glaucoma examination and were investigated by spectral-domain optical coherence tomography (Spectralis OCT, Heidelberg Engineering, Germany) measuring peripapillary RNFL thickness. All patients were examined in annual intervals over a period of at least three years with three successive OCT scans at each visit. Progressive changes of optic disc morphology between visit 1 and 4 were assessed by masked comparison of optic disc photographs. On the basis of morphological optic disc changes, the patients were classified into group 1 (no progression) and group 2 (progression). Longitudinal loss of RNFL thickness was compared between these groups.
Mean peripapillary RNFL thickness decreased in group 1 (no progression) by 0.59 µm within 1 year, 2.35 µm within 2 years, and 3.32 µm within 3 years follow-up. In group 2 (progression), the loss of mean RNFL thickness was significantly higher by 2.97 µm within 1 year (p=0.038, Mann-Whitney U test), 4.99 µm within 2 years (p=0.02), and 6.38 µm within 3 years (p=0.011). The loss of mean RNFL thickness exceeded the intrasession variability (mean 1.47 ± 0.6 µm) of three measurements at the same date in 48.0% of patients in group 1, and 92.3% in group 2 after three years follow-up. Regarding all study patients, the sensitivity for detection of progression by OCT was 44% after 3 years at a specifity of 93%.
Longitudinal measurements of RNFL thickness show a more pronounced reduction of RNFL thickness in patients with progression of optic disc changes than in patients without progression. This may indicate a higher sensitivity of OCT for early glaucomatous changes compared to the assessment of optic disc morphology. Intrasession variability may mask minor changes in RNFL thickness.
This PDF is available to Subscribers Only