April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Baseline Structural Measures Predict Functional Progression in Glaucoma
Author Affiliations & Notes
  • Mitra Sehi
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Palm Beach Gardens, Florida
  • Namita Bhardwaj
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Palm Beach Gardens, Florida
  • Maria C. Reyes
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Palm Beach Gardens, Florida
  • Yun Suk Chung
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Palm Beach Gardens, Florida
  • David S. Greenfield
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Palm Beach Gardens, Florida
  • Advanced Imaging in Glaucoma Study
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Palm Beach Gardens, Florida
  • Footnotes
    Commercial Relationships  Mitra Sehi, None; Namita Bhardwaj, None; Maria C. Reyes, None; Yun Suk Chung, None; David S. Greenfield, Alcon, Allergan, Topcon, Carl Zeiss Meditec, Heidelberg Engineering, Optovue Inc (C)
  • Footnotes
    Support  NIH Grant R01-EY013516, Bethesda, Maryland; P30EY014801 University of Miami core grant; and an unrestricted grant from Research to Prevent Blindness, New York, New York
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5093. doi:
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    • Get Citation

      Mitra Sehi, Namita Bhardwaj, Maria C. Reyes, Yun Suk Chung, David S. Greenfield, Advanced Imaging in Glaucoma Study; Baseline Structural Measures Predict Functional Progression in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5093.

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

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Abstract

Purpose: : To assess whether baseline optic nerve head (ONH) topography and retinal nerve fiber layer thickness (RNFLT) are predictive of glaucomatous visual field progression in glaucoma suspect and glaucomatous eyes.

Methods: : Participants with ≥30 months of follow-up were recruited from the longitudinal Advanced Imaging in Glaucoma Study. One eye per subject was enrolled. All eyes underwent standard automated perimetry (SAP), confocal scanning laser ophthalmoscopy (CSLO), time-domain optical coherence tomography (TDOCT) and scanning laser polarimetry using enhanced corneal compensation (SLPECC) every six months. Progression was assessed using pointwise linear regression analysis of SAP sensitivity values (ProgressorTM) and defined as significant sensitivity loss of ≥2 adjacent test locations in the same hemifield at >1dB/yr at p<0.01. Cox proportional hazard ratios (HR) were calculated to determine the predictive ability of baseline ONH and RNFL parameters for SAP progression using univariate and multivariate models.

Results: : Seventy-three eyes consisting of 43 glaucoma suspects and 30 glaucoma patients (mean age 63.2±9.5 years) were enrolled (mean follow-up 51.5±11.3 months). Four of 43 glaucoma suspects (9.3%) and 6 of 30 (20%) glaucomatous eyes demonstrated progression. Mean time to progression was 50.8±11.4 months. Using multivariate models, the following parameters were predictive of SAP progression (HR, 95% CI): abnormal CSLO temporal-inferior MRA classification (HR=4.2, p=0.02), SLPECC inferior RNFLT per 1 µm thinner (HR=1.23 [1.0 to 1.4], p=0.02), and TDOCT inferior RNFLT per 1 µm thinner (HR=1.11 [1.04 to 1.20], p=0.001).

Conclusions: : Abnormal baseline ONH topography and reduced RNFL are predictive of glaucomatous visual field progression in glaucoma suspect and glaucomatous eyes.

Keywords: optic nerve • nerve fiber layer • visual fields 
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