Abstract
Purpose :
To investigate the agreement of Bruch's membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer thickness (RNFLT) in patients with preperimetric, early, moderate, and advanced primary open angle glaucoma (POAG).
Methods :
68 eyes consisting of 15 advanced, 17 moderate, 28 early, and 8 preperimetric POAG were included as determined by mean deviation (MD) on Humphrey Visual Field (HVF) standard achromatic perimetry. BMO-MRW and peripapillary RNFLT data were obtained using spectral domain optical coherence tomography. Correlation analysis was done on global mean and sector values. The agreement of “outside normal” classification between BMO-MRW and RNFLT was also analyzed.
Results :
In perimetric glaucoma, there was a significant correlation between the mean global values in the BMO-MRW and RNFLT modules. The strongest correlation occurred in advanced glaucoma (r=0.704, p=0.003), followed by moderate (r=0.490, p=0.046) and early glaucoma (r=0.374, p=0.050). No significant correlation was found in the preperimetric glaucoma (r=0.543, p=0.164) group. With sector analysis, the strongest correlation between RNFLT and BMO-BRW was found in the inferotemporal (TI) sector of the advanced POAG (r=0.915, p=0.000) group. The agreement between BMO-MRW and RNFLT modules in global and sector “outside normal limits” classification ranged from 37% to 100%. In the TI sector, the advanced glaucoma group had the highest agreement (93.3%), followed by moderate (47.1%), early glaucoma (46.4%) and preperimetric glaucoma (37.5%), (p=0.011). In the superotemporal (TS) sector, the agreement between modules was similar in all glaucoma groups, ranging from 60.0%-64.7% (p=0.992). The RNFLT classified more global, TI and TS sectors as “outside normal limits” compared to the BMO-MRW. Global MD of HVF 24-2 visual fields correlated significantly with global RNFLT (r= 0.587, P=0.000) and global BMO-MRW (r= 0.361, P=0.003) in all enrolled patients.
Conclusions :
The agreement of BMO-MRW and RNFLT varies according to the stage of POAG. Advanced glaucoma showed better agreement compared to early glaucoma. The rate of “outside normal” classification is higher with RNFLT compared to BMO-MRW in all stages of glaucoma. RNFLT showed a stronger correlation with visual field defects compared to BMO-MRW.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.