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