July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Use Measurements by Optical Coherence Tomography as Baseline Risk Factors to Predict Confirmed Rapid Significant Visual Field Progression in Glaucoma
Author Affiliations & Notes
  • Xinbo Zhang
    Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
  • Ou Tan
    Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
  • Rohit Varma
    Ophthalmology, University of Southern California, Los Angeles, California, United States
  • Joel S Schuman
    Ophthalmology, New York University, New York City, New York, United States
  • David S Greenfield
    Ophthalmology, University of Miami, Miami, Florida, United States
  • David Huang
    Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Xinbo Zhang, None; Ou Tan, OptoVue (P), OptoVue (F); Rohit Varma, Carl Zeiss (R); Joel Schuman, Carl Zeiss (C); David Greenfield, Carl Zeiss (C), OptoVue (P); David Huang, OptoVue (P), OptoVue (F), OptoVue (I), OptoVue (C), OptoVue (R)
  • Footnotes
    Support  NIH Grant R01-EY013516
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2126. doi:
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      Xinbo Zhang, Ou Tan, Rohit Varma, Joel S Schuman, David S Greenfield, David Huang; Use Measurements by Optical Coherence Tomography as Baseline Risk Factors to Predict Confirmed Rapid Significant Visual Field Progression in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2126.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine whether optical coherence tomography (OCT) measurements are useful in predicting confirmed rapid significant glaucomatous visual field (VF) progression.

Methods : We analyzed the data from perimetric glaucoma (PG) patients enrolled in the multi-center longitudinal Advanced Imaging for Glaucoma Study (www.AIGStudy.net) who were followed every 6 months. Fourier-domain (FD) OCT were used to measure peripapillary retinal nerve fiber layer (NFL) and macular ganglion cell complex (GCC). Standard automated perimetry was used to assess VF. Starting from the 4th visits, ordinary linear regressions were performed separately for MD and VFI on age to calculate slopes and p-values. MD rapid progression was reached when the MD slope is below -0.5 db per year and the VFI rapid progression was reached when the VFI slope is below -1% per year. Significant slope was reached when the corresponding p-value is less than 0.05. The confirmed rapid significant progression (CRSP) was reached when two consecutive MD or VFI slopes were rapid and significant. Minimum number of visits for CRSP was 5. The Cox proportional hazard model was used to calculate the hazard ratios (HR) for baseline risk factors.

Results : The analysis included 219 eyes (143 participants) with average age of 62.8, among which 82(57%) are female and 15 (11%) are African Americans. The average PSD at baseline was 5.6 while the average mean deviation (MD) was -4.8. The average follow-up time was 60 months. In the cohort, 34 eyes had confirmed rapid significant progression. The best risk was Ganglion cell complex focal loss volume (GCC-FLV, a parameter to summarize localized GCC loss) with hazard ratio 1.40 per 5% GCC-FLV higher, p =0.04.

Conclusions : Glaucoma patients with higher GCC-FLV as measured by FD-OCT are more likely to have confirmed rapid significant visual field progression. Clinicians may use baseline GCC-FLV to determine whether more aggressive treatment may be needed.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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