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alisa prager, Donald Hood, Jeffrey M Liebmann, C Gustavo De Moraes, Lama Al-Aswad, Qi Yu, George A Cioffi, Dana Blumberg; Glaucoma-related macular damage as measured by OCT and vision-related quality of life. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5821.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the relationship between vision-related quality of life (VRQoL) and structural macular damage as measured by ganglion cell-inner plexiform (RGC+) layer thickness in open angle glaucoma patients.
107 patients (214 eyes) with the entire range of glaucomatous damage underwent standard automated perimetry 10-2 visual field test (Swedish Interactive Threshold Algorithm protocol) and Cirrus SD-OCT macular cube 512x128 scans. Patients completed the National Eye Institute Visual Function Questionnaire (NEIVFQ-25) within 6 months of OCT testing. Linear regression analyses were conducted to determine the relationship between RGC+ layer thickness quantitative measures, 10-2 binocular visual field (VF) mean deviation, and Rasch-calibrated NEIVFQ-25 scores. Chi-squared test was used to categorize NEIVFQ-25 (“high” vs. “low”) relative to patterns of glaucoma-related macular damage on OCT (defined as diffuse vs. focal). Diffuse damage on OCT was defined as decrease to the 5% level both superiorly and inferiorly in any of the four temporal RGC+ wedges, and to the 1% level in at least two of the four temporal RGC+ wedges (figure 1).
There was a significant correlation between integrated 10-2 scores and average RGC+ thickness (better eye β=0.12dB, p<0.001, worse eye β=0.07dB, p<0.012, binocular β=0.12dB, p<0.001). There was also a significant correlation between NEIVFQ-25 scores and integrated 10-2 scores (binocular 10-2 sensitivity β=1.14, p=0.001). However, the association between NEIVFQ-25 scores and RGC+ quantitative measures was not significant. On the other hand, among those with macular damage on OCT, patients with widespread, diffuse RGC+ loss reported lower NEIVFQ-25 scores than those with deep, focal defects. 14 out of 18 patients (78%) with low NEIVFQ-25 scores had diffuse RGC+ loss compared to 26 out of 52 patients (50%) with high NEIVFQ-25 scores (p=0.02). Figure 1 provides examples of patients’ eyes with nearly identical average and minimum RGC+ thicknesses on RGC+ analysis, but different patterns of macular damage on deviation map.
RGC+ layer summary measures did not predict VRQoL. However, low NEIVFQ-25 scores appear to be associated with more diffuse macular damage, whereas higher NEIVFQ-25 appears to be associated with more focal damage.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Example of patient (OD) with A) focal RGC+ loss on deviation map and B) diffuse RGC+ loss on deviation map.
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