Abstract
Purpose :
To examine changes in structural parameters and functional progression in normal weight (NW: Body Mass Index, BMI <25), overweight (OW: BMI 25-30) and obese (OB: BMI> 30) patients with Open-Angle Glaucoma (OAG) over 5 years.
Methods :
111 patients with OAG (38 NW; 40 OW; 33 OB, BMI> 30) were assessed for structural optic nerve head parameters as measured by Heidelberg Retinal Tomograph 3 (HRT3) at baseline and every 6 months for a 5-year period. 77 patients (29 NW; 28 OW; 20 OB) were assessed at 5-year follow-up. Functional disease progression was monitored with 24-2 Swedish Interactive Thresholding Algorithm visual field exam and was defined as two consecutive visits with mean deviation decrease ≥2 and/or Advanced Glaucoma Intervention Study increase ≥2 compared to baseline.
Results :
Cup area increased from 0.795 (95% CI: 0.615, 0.995) at baseline to 0.881 (0.690, 1.093) at 5 years, change of 0.082 (0.024, 0.138) in NW (p<0.05), from 0.857 (0.702, 1.025) at baseline to 0.890 (0.726, 1.068) at 5 years, change of 0.032 (-0.037, 0.099) in OW, from 0.820 (0.654, 1.003) at baseline to 0.833 (0.665, 1.019) at 5 years, change of 0.013 (-0.041, 0.066) in OB; cup volume significantly increased from 0.287 (0.184, 0.389) at baseline to 0.340 (0.237, 0.444) at 5 years, change of 0.054 (0.020, 0.088) in NW (p<0.05), from 0.286 (0.205, 0.367) at baseline to 0.302 (0.219, 0.385) at 5 years, change of 0.016 (-0.019, 0.051) in OW, decreased from 0.265 (0.165, 0.365) at baseline to 0.259 (0.160, 0.359) at 5 years, change of -0.005 (-0.033, 0.023) in OB; cup/disk area increased from 0.388 (0.315, 0.460) at baseline to 0.426 (0.352, 0.500) at 5 years, change of 0.038 (0.008, 0.069) in NW (p<0.05), from 0.402 (0.344, 0.460) at baseline to 0.425 (0.362, 0.488) at 5 years, change of 0.023 (-0.012, 0.057) in OW, from 0.387 (0.322, 0.451) at baseline to 0.393 (0.328, 0.458) at 5 years, change of 0.006 (-0.020, 0.033) in OB. Smaller increases/larger decreases in cup area, cup volume and cup/disk area ratio were more predictive of functional progression in OW patients, compared to NW or OB patients, with a significant difference between BMI groups (p=0.0064, 0.0024, 0.0085, respectively).
Conclusions :
Changes in structural parameters may be more predictive of functional progression in OW OAG patients than in NW patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.