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Christopher C. Teng, Gustavo V. De Moraes, Sung Chul Park, Celso Tello, Robert Ritch, Jeffrey M. Liebmann; Baseline CSLO Optic Nerve Data and VF Progression in Treated Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4142.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate whether baseline Confocal Scanning Laser Ophthalmoscopy (CSLO) parameters are associated with VF progression in eyes with established and treated glaucoma.
Retrospective observational cohort. Treated glaucoma patients (abnormal achromatic perimetry and optic disc appearance), with reliable baseline CSLO imaging using Heidelberg Retinal Tomograph (HRT II), and >=5 24-2 SITA VF tests after the HRT were included. VF progression was evaluated using automated pointwise linear regression (PLR). VF progression was defined as at least 2 adjacent test points in the same hemifield progressing >1.0 dB/yr at p<0.01. Stereometric parameters and Moorfields Regression Analysis (MRA) results were analyzed in univariate and multivariate models adjusted for follow-up time to determine the role of baseline variables in the prediction of VF progression outcomes. Variables with p<=0.10 in the univariate analysis were entered in the multivariate analysis.
115 eyes (115 patients; mean age, 66.5±12.7; mean baseline MD, -4.2±3.6; 58% women, 88% European descent) were analyzed. 35 patients had VF progression. Patients performed 9.2±2.5 VF tests spanning 4.9±1.4 yrs after the baseline CSLO. In the univariate model, significant variables (p<0.05) were: disc area, cup area, rim area, rim volume, cup shape measure, mean RNFL, rim area/disc area ratio, FSM discriminant function value, RB discriminant function value, and Moorfields Regression Analysis. In the multivariate model, when evaluating CSLO measures, variables associated with progression were global cup shape measure (OR=1.08, p<0.01); inferotemporal cup area (OR=1.10, p<0.01); and FSM discriminant function value (OR=0.997, p<0.01). When evaluating all MRA variables, only inferotemporal MRA was significant (OR=4.37, p<0.01).
In assessing baseline CSLO parameters in patients with treated glaucoma, an abnormal inferotemporal disc was associated with VF progression. This may indicate that the inferotemporal disc is more susceptible to glaucomatous damage, leading to VF progression.
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