March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Analysis Of Progression In Glaucoma Using Spectral-domain Optical Coherence Tomography
Author Affiliations & Notes
  • Julia M. Wessel
    Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
  • Folkert K. Horn
    Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
  • Ralf P. Tornow
    Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
  • Friedrich E. Kruse
    Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
  • Christian Y. Mardin
    Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
  • Robert Lämmer
    Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
  • Footnotes
    Commercial Relationships  Julia M. Wessel, None; Folkert K. Horn, None; Ralf P. Tornow, None; Friedrich E. Kruse, None; Christian Y. Mardin, None; Robert Lämmer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 232. doi:
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      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.

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

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Abstract

Purpose: : 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.

Methods: : 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.

Results: : 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%.

Conclusions: : 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.

Keywords: optic disc • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 
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