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Masayuki Inuzuka, Akira Sawada, Hiroko Inuzuka, Tetsuya Yamamoto; Annual rates of change of mRNFL, mGCIPL, and cpRNFL in various stages of glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5526. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To explore changes in the macula retinal nerve fiber layer (mRNFL), macular ganglion cell layer and inner plexiform layer (mGCIPL), and circumpapillary retinal nerve fiber layer (cpRNFL) in mild, moderate, and severe stages of normal tension glaucoma (NTG) using spectral domain optical coherence tomography.
We retrospectively examined 218 NTG eyes assigned to age-, refraction-, and intraocular pressure (IOP)-matched groups based on initial mean deviation (MD; Humphrey Field Analyzer program Central 30-2): mild (MD > -6 dB), moderate (-6 dB ≧ MD ≧-12 dB), and severe (-12 dB > MD >-20 dB). and calculated annual rates of change in mRNFL, mGCIPL, and cpRNFL thickness. Kruskal-Wallis test and Bonferroni correction were used for statistical analysis.
There were no significant differences among the stages in terms of age, spherical equivalent refraction, or average IOP during the 6-year follow-up period. There were significant initial differences in mGCIPL, cpRNFL, and mRNFL among the three groups (P < 0.0001 in all 6 sectors, except for mRNFL in the superonasal sector). There were no significant differences in the rate of change for the mRNFL and mGCIPL among the groups in any of the 6 sectors. However, there was a significant difference in the rate of change of the cpRNFL among the groups (in all sectors: P < 0.0001).
Changes in the mRNFL and mGCIPL can reflect progression of NTG even in its advanced stage (MD >-20 dB). However, the implication of such changes in the cpRNFL may be less clear due to a floor effect in the advanced stage of glaucoma (MD >-20 dB).
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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