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L. M. Zangwill, S. Jain, R. N. Weinreb, G. L. Trick, J. D. Brandt, G. A. Cioffi, A. L. Coleman, J. Piltz-Seymour, M. A. Kass, CSLO Ancillary Study to the OHTS Study Group; The Rate of Topographic Optic Disc Change is Faster in Eyes Developing POAG Than in Eyes Not Developing POAG: The Confocal Scanning Laser Ophthalmoscopy (CSLO) Ancillary Study to the Ocular Hypertension Treatment Study (OHTS). Invest. Ophthalmol. Vis. Sci. 2010;51(13):2048.
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To compare rates of change in topographic optic disc parameters in ocular hypertensive eyes that do/do not develop primary open angle glaucoma (POAG) and to evaluate factors that influence the rate of change.
The rate of change of Heidelberg Retina Tomograph (HRT) optic disc parameters was measured in 439 participants (866 eyes) in the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the OHTS (median follow-up: 10 years, with 50 participants (64 eyes) developing POAG, defined by OHTS criteria by visual fields and/or stereo-photographs. Multivariable mixed effects models adjusting for baseline age, visual field PSD, stereophotograph-based horizontal cup disc ratio corneal thickness, IOP, race and disc area were used to compare slopes of topographic optic disc parameters in eyes that did/did not develop POAG.
The slope of rim area loss was significantly different from zero in eyes that did and did not develop POAG (both p<0.0001). In both univariate and multivariable analyses, the rate of rim area loss (95% CI) was significantly faster in eyes developing POAG than in eyes that did not (univariate rate: -0.014 (-0.018, -0.009) mm2/yr and -0.002 (-0.015, -0.007) mm2/yr, respectively). The rates of change of other topographic optic disc parameters including cup volume, and rim disc ratio were also significantly faster in eyes that developed POAG compared to eyes that did not. In multivariable analyses, the slope of loss was consistently greater in eyes with larger stereo-photograph based cup disc ratios at baseline.
The rate of structural change is approximately 5 times faster in eyes that developed POAG compared to eyes that did not. These results suggest that measuring the rate of structural change can provide important information for the clinical management of ocular hypertensive patients.
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