Abstract
Purpose :
To investigate the risk factors for unilateral retinal nerve fiber layer defect (RNFLD) progression in patients with bilateral primary open-angle glaucoma (POAG).
Methods :
We included patients showing unilateral RNFLD progression in eyes with bilateral POAG who were followed up for more than 5 years. Patients underwent stereo disc photography, retinal nerve fiber layer photography (RNFLP), and Humphrey visual field (HVF). In addition, spectral-domain optical coherence tomography was performed for lamina cribrosa (LC) examination. LC abnormalities were defined as disinsertion, hole, and defect in LC. Progression was determined as an appearance of a new RNFLD, enlargement and deepening of RNFLD on RNFLP Cox proportional hazards regression analysis was performed to determine the risk factors for progression.
Results :
A total of 23 patients with the mean follow-up period of 8.8 ± 1.9 years were included. There were no significant difference in the baseline (15.4 ± 3.2 vs 16.0 ± 3.3 mmHg, P = 0.262) and mean follow-up IOPs (13.2 ± 2.1 vs 12.9 ± 2.4, P = 0.236) between eyes with and without progression. The percentage of eyes showing LC abnormality was similar between eyes with (65.2%) and without (52.2%) progression (P = 0.55). However, larger number of eyes with optic disc hemorrhage (ODH) was found in progression group than in non-progression group (52.2% vs 17.3%, P = 0.013). A multivariate Cox proportional hazard model revealed that ODH (hazard ratio = 5.182, 95% confidence interval 1.339 – 12.058 P = 0.017) was significantly associated with unilateral RNFLD progression.
Conclusions :
In patients with bilateral POAG, eyes showing ODH should be carefully monitored for structural progression.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.