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K. Sung, Y. Nam, B. Moon, J. Cho, S. Kang, M. S. Kook; Glaucoma Progression Detection by Retinal Nerve Fiber Layer Measurement With Scanning Laser Polarimetry; Event vs. Trend Analysis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4009.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the Scanning laser polarimetry (SLP, GDx VCC; Carl Zeiss Meditec, Dublin, CA) retinal nerve fiber layer (RNFL) measurement for glaucoma progression and compare this finding with visual field (VF) outcomes.
Long-term test-retest measurement variability was determined on control group (54 stable glaucomatous suspects). Two hundred and ninety-nine eyes of 152 glaucomatous subjects with at least 4 years follow-up, 5 reliable VFs and 5 qualified SLP exams were enrolled. VF progression was defined by modified Anderson criteria. SLP progression was defined as RNFL reduction beyond the 95% confidence interval of long-term test-retest variability of SLP RNFL thickness measurements as compared to baseline in two consecutive exams (event analysis (EA)). The slope of RNFL thickness change over time was determined by linear regression analysis (trend analysis (TA)). Negative slope with p value <0.05 was considered as progression.
Average age of participants was 52.0±16.2 years, VF mean deviation (MD) was -4.19±5.5dB at baseline, while last visit VF MD was -4.59±6.2dB. Forty-one eyes (13.7%) progressed by VF modified Anderson criteria, 71 eyes (23.7%) by SLP EA, and 26 eyes (8.7%) by SLP TA. Among progressors by SLP, 11 from 71 eyes and 5 from 26 eyes also progressed by VF modified Anderson criteria. Average baseline VF MD and RNFL thickness were significantly lower in VF progressors than non-progressors ( -6.85±5.5dB vs. -3.76±5.3dB, p<0.001, 47.4±8.1microns vs. 52.1±9.3 microns, p=0.002). However, progressors by SLP EA had significantly higher baseline RNFL thickness than non-progressors (55.5±8.7microns vs. 50.2±9.3 microns, p<0.001) and baseline VF MD was not different between two groups (-4.13±5.8 dB vs. -4.20±5.5, dB, p=0.92).
Both EA and TA of SLP showed poor agreement with VF outcome in glaucoma progression detection. EA defined more eyes as progressed than TA. Worse baseline VF MD was related with VF progression, while thicker RNFL thickness was related with SLP progression.
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