May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Detection of Glaucoma Progression With Optical Coherence Tomography Macular Scans
G. Wollstein; K. Sung; H. Ishikawa; R. A. Bilonick; L. Kagemann; M. L. Gabriele; K. A. Townsend; C. Mattox; J. G. Fujimoto; J. S. Schuman
Author Affiliations & Notes
  • G. Wollstein
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • K. Sung
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • H. Ishikawa
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • R. A. Bilonick
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • L. Kagemann
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • M. L. Gabriele
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • K. A. Townsend
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • C. Mattox
    New England Eye Center, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
  • J. G. Fujimoto
    Dept. of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts
  • J. S. Schuman
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • Footnotes
    Commercial Relationships G. Wollstein, Carl Zeiss Meditec, Inc., R; K. Sung, None; H. Ishikawa, Carl Zeiss Meditec, Inc., R; R.A. Bilonick, None; L. Kagemann, None; M.L. Gabriele, None; K.A. Townsend, None; C. Mattox, None; J.G. Fujimoto, Carl Zeiss Meditec, Inc., P; J.S. Schuman, Alcon; Allergan; Carl Zeiss Meditec, Inc.; Merck; Optoview; Heidelberg Engineering, F; Carl Zeiss Meditec, Inc., P; Alcon; Allergan; Carl Zeiss Meditec, Inc.; Clarity; Merck; Heidelberg Engineering, R.
  • Footnotes
    Support NIH EY13178, EY11289, EY08098, EY13078; NSF ECS-0119452, BES-0522845; AFOSR FA9550-040-1-0011; MFEL FA9550-040-1-0046; Eye and Ear Foundation (Pittsburgh, PA); Research to Prevent Blindness
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 3336. doi:
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      G. Wollstein, K. Sung, H. Ishikawa, R. A. Bilonick, L. Kagemann, M. L. Gabriele, K. A. Townsend, C. Mattox, J. G. Fujimoto, J. S. Schuman; Detection of Glaucoma Progression With Optical Coherence Tomography Macular Scans. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3336.

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Abstract

Purpose:: To assess the ability of optical coherence tomography (OCT; StratusOCT, Carl Zeiss Meditec, Dublin, CA) macular scans to detect glaucomatous progression over time.

Methods:: Twenty-eight eyes of glaucoma patients and glaucoma suspects (19 subjects) with at least 4 reliable visual fields (VF) and good quality StratusOCT macular scans were enrolled. VF progression was defined by mean deviation (MD) decrease by 2dB from baseline level (MD criteria-MDC) and by subjective assessment by glaucoma experts (SA). Total macular thickness (TMT) and circumpapillary nerve fiber layer (cNFL) as provided by StratusOCT software were used for the analysis. We also assessed the performance after segmenting the retina into the NFL, ganglion cell layer and the inner plexiform layer (NFL+ IRC) using a software of our own design. A mixed effects model was created to assess the overall slope of changing thickness. The model accounted for scan quality. OCT progression was defined as thinning which exceeded the 95% confidence interval of reported reproducibility error.

Results:: Mean baseline VF MD was -6.3±6.9dB and mean final MD was -6.9±6.8dB. The mean follow-up period was 2.8±0.6 years. The overall slope for TMT, NFL+IRC and cNFL showed a negative (thinning) slope for eyes that were defined as progressors by SA and positive slope for those defined as non-progressors. No significant difference was observed between slopes of progressors and non-progressors for the three parameters. Using the progression criteria for each parameter, the survival curve was steepest for NFL+IRC followed by cNFL, and MDC and shallowest for TMT. The difference among the curves was not statistically significant. The agreement among eyes labeled as progressors using the various criteria was poor.

Conclusions:: Macular OCT measurements demonstrated change over time but the poor agreement with OCT circumpapillary NFL changes and VF might indicate either a high false positive rate or that the relationship between structural and functional changes may not be temporally coincident.

Clinical Trial:: www.clinicaltrials.gov NCT00343746

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • macula/fovea • nerve fiber layer 
© 2007, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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