Abstract
Purpose :
To investigate whether morphological and functional changes in optical coherence tomography (OCT) and visual field (VF) examination correlate with glaucoma progression using trend-based analysis.
Methods :
This retrospective study included 304 eyes of 190 patients with primary open angle glaucoma who performed spectral-domain OCT (SD-OCT, 3D OCT-2000; TOPCON). Patients were divided into a non-advanced (263 eyes of 158 patients; VF defect better than 12 dB in mean deviation (MD)) and an advanced (41 eyes of 32 patients; VF defect worse than 12 dB in MD) group at the first VF examination. The ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thickness were measured every six months over three years by SD-OCT. In each group, we performed trend-based analysis of mean GCC and mean RNFL thickness to determine progression, which was defined as an MD value decrease in VF of 3 dB or more in three years. The correlation of VF progression with mean GCC or RNFL thickness was estimated by chi-square test.
Results :
In the non-advanced group, progression was detected in 23.6, 8.4 and 16.0 % of eyes by trend-based analysis of mean GCC thickness, mean RNFL thickness and VF examination, respectively. The eyes with progression based on trend-based analysis of mean GCC thickness and mean RNFL thickness corresponded to 42.9% and 23.8% of eyes with progression in VF examination, respectively (P < 0.001 and P < 0.001, respectively). The trend-based analysis of mean GCC thickness was significantly able to detect progression more accurately compared with that of mean RNFL thickness in a non-advanced group (P < 0.0001). In the advanced group, progression was detected in 14.6, 31.7 and 22.0% of eyes by trend-based analysis of mean GCC thickness, mean RNFL thickness and VF examination, respectively. The eyes with progression in the trend-based analysis of mean GCC thickness and mean RNFL thickness corresponded to 33.3 and 44.4% of eyes with progression in VF examination, respectively (P = 0.07 and P = 0.35, respectively). The glaucoma progression detection rate was not significantly different between the trend-based analysis of mean GCC and mean RNFL thickness in the advanced group (P = 0.07).
Conclusions :
Trend-based analysis of mean GCC thickness on SD-OCT may be superior to that of mean RNFL thickness for glaucoma progression prediction in early glaucoma.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.