March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Nerve Fiber Layer and Ganglion Cell Complex Measurements by Optical Coherence Tomography as Risk Factors for Visual Field Progression in Glaucoma
Author Affiliations & Notes
  • David Huang
    Casey Eye Institute, Oregon Health & Science Univ, Portland, Oregon
  • Xinbo Zhang
    Ophthalmology, Oregon Health & Science University, Portland, Oregon
  • Rohit Varma
    Ophthalmology, USC, Doheny Eye Institute, Los Angeles, California
  • David S. Greenfield
    Ophthalmology, Bascom Palmer Eye Institute, Palm Beach Gardens, Florida
  • Joel S. Schuman
    Ophthalmology, UPMC Eye Center/Univ of Pittsburgh, Pittsburgh, Pennsylvania
  • Advanced Imaging for Glaucoma Study Group
    Casey Eye Institute, Oregon Health & Science Univ, Portland, Oregon
  • Footnotes
    Commercial Relationships  David Huang, Carl Zeiss Meditec, Inc. (P), Optovue, Inc. (F, I, C, P, R); Xinbo Zhang, None; Rohit Varma, Aquesys (C), Carl Zeiss Meditec, Inc. (R), Heidelberg Engineering (R), Optovue, Inc. (R), Replenish (C); David S. Greenfield, Carl Zeiss Meditec, Inc. (F), Heidelberg Engineering (F), Optovue, Inc. (F, C), Topcon (F, C); Joel S. Schuman, Carl Zeiss Meditec, Inc. (P)
  • Footnotes
    Support  NIH Grant R01-EY013516; Unrestricted Grant to Casey Eye Institute from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2260. doi:
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      David Huang, Xinbo Zhang, Rohit Varma, David S. Greenfield, Joel S. Schuman, Advanced Imaging for Glaucoma Study Group; Nerve Fiber Layer and Ganglion Cell Complex Measurements by Optical Coherence Tomography as Risk Factors for Visual Field Progression in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2260.

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

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Abstract

Purpose: : To determine whether optical coherence tomography (OCT) measurements are useful in predicting the worsening of glaucomatous visual field (VF) defects.

Methods: : We analyzed the data from perimetric glaucoma (PG) patients enrolled in the multi-center longitudinal Advanced Imaging for Glaucoma Study (www.AIGStudy.net). Both time-domain (TD) and Fourier-domain (FD) OCT were used to measure peripapillary retinal nerve fiber layer (NFL) thickness. Macular ganglion cell complex (GCC) thickness maps were measured with FD-OCT. Standard automated perimetry was used to assess VF. Subjects were followed every 6 months. VF glaucoma progression was defined as three consecutive follow-up VF’s that show consistent focal worsening of defects (three completely filled black triangles) by Humphrey Glaucoma Progression Analysis (GPA) software. The Cox proportional hazard model was used to calculate the hazard ratios (HR) for the risk factors; the results were adjusted for correlation between the eyes from the same individual. A multivariate model was fitted for each of the OCT parameters with age and VF pattern standard deviation (PSD).

Results: : The analysis included 340 eyes (222 participants) with average age of 61.8, among which 127 (57%) are female and 24 (11%) are African Americans. The average PSD at baseline was 5.6 dB while the average mean deviation (MD) was -4.8 dB. The average follow-up time was 36 months. In the cohort, 35 eyes had VF progression. Independent risk factors for visual field progression included overall NFL thickness measured by TD-OCT (HR = 1.33 per 10 micron thinner, p = 0.01), overall NFL thickness measured by FD-OCT (HR = 1.46, per 10 micron thinner, p = 0.05) and Ganglion cell complex thickness measured by FD-OCT (HR = 1.60 per 10 micron thinner, p < 0.001).

Conclusions: : Glaucoma patients with thinner NFL or GCC are more likely to have worsening of visual field defects. NFL and GCC thickness measured by OCT over the follow-up period are predictive of VF progression among perimetric glaucoma patients, even after controlling for age and disease severity (VF PSD) in multivariate analysis. OCT has prognostic value in glaucoma.

Keywords: imaging/image analysis: clinical • ganglion cells • nerve fiber layer 
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