July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Hierarchical cluster analysis of peripapillary retinal nerve fiber layer damages and macular ganglion cell loss in open angle glaucoma
Author Affiliations & Notes
  • Kwanghyun Lee
    department of ophthalmology, Yonsei college of medicine, Seoul, Korea (the Republic of)
  • Sangah Kim
    department of ophthalmology, Yonsei college of medicine, Seoul, Korea (the Republic of)
  • Chan Keum Park
    department of ophthalmology, Yonsei college of medicine, Seoul, Korea (the Republic of)
  • Hyoung Won Bae
    department of ophthalmology, Yonsei college of medicine, Seoul, Korea (the Republic of)
  • Sang Yeop Lee
    department of ophthalmology, Yonsei college of medicine, Seoul, Korea (the Republic of)
  • Gong Je Sung
    department of ophthalmology, Yonsei college of medicine, Seoul, Korea (the Republic of)
  • Chan Y Kim
    department of ophthalmology, Yonsei college of medicine, Seoul, Korea (the Republic of)
  • Footnotes
    Commercial Relationships   Kwanghyun Lee, None; Sangah Kim, None; Chan Keum Park, None; Hyoung Won Bae, None; Sang Yeop Lee, None; Gong Je Sung, None; Chan Kim, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6138. doi:
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      Kwanghyun Lee, Sangah Kim, Chan Keum Park, Hyoung Won Bae, Sang Yeop Lee, Gong Je Sung, Chan Y Kim; Hierarchical cluster analysis of peripapillary retinal nerve fiber layer damages and macular ganglion cell loss in open angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6138.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To categorize the structural progression of glaucoma, as detected by optical coherence tomography guided progression analysis (OCT GPA), for the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) using hierarchical cluster analysis.

Methods : A total of 164 eyes were enrolled. Peripapillary RNFL thickness and macular GCIPL thickness were assessed using Cirrus HD-OCT, and progressive GCIPL and RNFL thinning were detected using event GPA OCT. Structural progression was classified using hierarchical cluster analysis. Visual field progression was defined as linear regression analysis of mean deviation and guidelines for early glaucoma guidance. Clinical parameters of each cluster were compared.

Results : There were three groups: stable, peripapillary RNFL thinning progression without macular GCIPL involvement, and both peripapillary RNFL and macular GCIPL thinning progression groups. The both peripapillary RNFL and macular GCIPL thinning progression group showed relatively more reduction of peripapillary RNFL thickness in the inferotemporal area and more VF progression. Superotemporal peripapillary RNFL thinning at the 10 and 7 o’ clock areas was related to superior and inferior GCIPL progression, respectively.
The visual field progression of the perinasal scotoma region was the most prominent in the RNFL only progression group.

Conclusions : There are differences between the rate of change and the location of RNFL thinning progression among the three groups categorized based on the structural progression of glaucoma. The topographic relationship between the peripapillary RNFL thinning progression and macular GCIPL thinning progression appears to be different between the superior and inferior macula. In particular, superior macular GCIPL thinning progression is less associated with the progression of peripapillary RNFL thinning. The location of the VF progression is also different among the three clusters. Therefore, macular GCIPL analysis alone can overlook the change in the outer macula that may affect the peripheral VF.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Dendrogram showing the three clusters classified using hierarchical cluster analysis

Dendrogram showing the three clusters classified using hierarchical cluster analysis

 

Clockwise plot shows the different pattern of retinal nerve fiber layer (RNFL) progression between cluster 2 (only RNFL progression detected group) and cluster 3 (both RNFL and GCIPL progression detected group).

Clockwise plot shows the different pattern of retinal nerve fiber layer (RNFL) progression between cluster 2 (only RNFL progression detected group) and cluster 3 (both RNFL and GCIPL progression detected group).

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