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Philip I. Niles, Mitra Sehi, Namita Bhardwaj, David S. Greenfield, Advanced Imaging in Glaucoma Study Group; Detection of Progressive Macular Thickness Loss Using Optical Coherence Tomography in Glaucoma Suspect and Glaucomatous Eyes. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2116.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the rate of macular thickness loss using optical coherence tomography (OCT) in progressing versus non-progressing eyes using various methods to define functional progression.
Glaucoma suspect and glaucomatous eyes with >=30 months of follow-up were prospectively enrolled. All eyes underwent standard automated perimetry (SAP, 24-2 SITA Standard) and OCT imaging (Stratus OCT, Carl Zeiss Meditec, Dublin, CA) every 6 months. The annual rate of macular thickness loss using OCT was calculated using linear regression analysis. Functional progression was determined using Early Manifest Glaucoma Trial (EMGT) criterion, pointwise linear regression (PLR) using Progressor® software defined as 2 contiguous locations losing >=1.0 dB/year at p <1% in the same hemifield, and the 3-omitting method. Statistical analysis was performed using one-way ANOVA and random effect models.
72 eyes (mean age 62.6±12.5) consisting of 43 glaucoma suspect and 29 glaucomatous eyes were enrolled with a mean follow-up of 4.4±1.2 years. 14 eyes progressed using PLR, 11 eyes using EMGT, and 6 eyes using 3-omitting method. Using PLR, there was a significantly greater rate of macular thickness loss in progressing vs. non-progressing eyes in the temporal outer (-1.9±3.0 vs 0.33±2.8µm/yr; p=0.01), nasal inner (-1.70±0.73 vs 0.14±0.36 µm/yr; p=0.03), superior inner (-2.15±4.6 vs 0.51±3.0 µm/yr; p=0.009) and temporal inner region (-2.60±5.0 vs 0.38±2.34 µm/yr; p=0.02). Using the 3-omitting method, there was a significantly greater rate of thickness loss in progressing vs. non-progressing eyes in the temporal inner macular region (-4.3±7.2 vs -0.49±2.4 µm/yr; p=0.04). The rates of macular thickness loss were similar (p>0.05) between progressing and non-progressing eyes identified using EMGT. Using a linear mixed-effect model, the rate of loss in the nasal inner (p=0.02) and temporal outer (p=0.02) macular region were associated with optic disc hemorrhage.
Eyes with SAP progression have significantly greater rates of macular thickness atrophy measured using OCT consistent with retinal ganglion cell loss compared with non-progressing eyes.
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