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C. Rodarte, L. M. Alencar, L. M. Zangwill, C. Bowd, P. A. Sample, R. N. Weinreb, F. A. Medeiros; Intereye Relationship in Rates of Retinal Nerve Fiber Layer Loss in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4018.
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To evaluate the intereye relationship in rates of progressive retinal nerve fiber layer thickness (RNFLT) loss in glaucoma.
The study included both eyes of 144 glaucoma and glaucoma suspect patients recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) with a median follow up of 2.61 (±0.81) years. Images were obtained annually using the GDx with enhanced corneal compensation along with optic nerve head stereophotographs and standard automated perimetry (SAP) visual fields. Progression was determined for each eye by masked review of optic nerve head stereophotographs and/or a "likely progression" result on the Guided Progression Analysis software for SAP. Joint multivariate mixed models were used to evaluate rates of GDx measured RNFLT loss in both eyes of each subject and the intereye association.
There was a strong correlation in the rates of RNFLT loss between the right and left eyes of glaucoma and glaucoma suspect patients followed over time (r = 0.83; P < 0.001). During follow-up, 25 (17%) patients showed progression with stereophotographs and/or SAP. Of these, 24 showed progression by conventional methods in only one eye. Comparing both eyes of these 24 patients showed that RNFLT measurements decreased significantly over time for both the progressing (-0.97 µm/yr, P<0.001) and the contralateral non-progressing eyes (-0.71 µm/yr, P<0.001). Rates of RNFLT loss in the contralateral non-progressing eyes of progressing patients were significantly greater than rates of change in patients in whom none of the eyes progressed (-0.71 µm/yr vs. -0.25 µm/yr, respectively; P<0.001).
There was a significant intereye correlation in the rate of RNFLT loss for glaucoma and glaucoma suspect patients. The rate of RNFLT loss in the nonprogressing eyes of patients showing only unilateral progression by conventional methods was significantly faster than in those patients with no progression in either eye. This suggests that patients with clinical progression in one eye may have progression in the contralateral eye that is detectable by GDx ECC but not yet by conventional methods.
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