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K. Sung, G. Wollstein, H. Ishikawa, R. A. Bilonick, L. Kagemann, M. L. Gabriele, K. A. Townsend, C. Mattox, J. G. Fujimoto, J. S. Schuman; Evaluation of Optical Coherence Tomography Measurement of Glaucoma Progression. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3337.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the optical coherence tomography (OCT; StratusOCT, Carl Zeiss Meditec, Dublin, CA) measurement of glaucoma progression.
44 glaucomatous and 8 glaucoma suspect eyes of 32 subjects with at least 4 reliable visual fields (VF) and 4 qualified OCT scans were enrolled. VF progression was defined subjectively by 2 glaucoma experts assessment or by a 2dB decline of VF mean deviation (MD) from baseline value. OCT progression was defined as retinal nerve fiber layer (RNFL) thinning beyond the 95% confidence interval of reproducibility error of OCT RNFL thickness measurements as compared to baseline. The slope of RNFL thickness change over time was determined by a mixed effects model. The model accounted for the scan quality.
Average age at baseline was 69.0±12.0 years and the mean follow-up duration was 3.1±0.7 years (range:1.6-4.6 years). The average number of VFs was 5.6±1.6 and of OCTs was 5.5±1.1. Baseline average VF MD was -6.6±6.7dB, while last visit VF MD was -6.7±6.4dB. 18 eyes progressed by VF subjective assessment, 7 eyes progressed by VF MD criteria and 10 eyes by OCT RNFL; 3 eyes progressed by both VF subjective assessment and OCT RNFL, and 2 eyes by both VF MD criteria and OCT RNFL. The estimated probability of progression was higher for OCT, but the difference was not significant (p=0.98). The estimated slope of RNFL thickness for eyes that were defined as progressors by subjective VF assessment was -0.84 microns/year and for non-progressors -0.35 microns/year (p=0.20).
OCT glaucoma progression analysis demonstrated poor agreement between functional (VF) and structural (OCT) progression. These findings suggest that structural and functioanl glaucomatous changes often may not be temporally coincident.
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