July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Peripapillary RNFL loss precedes Macular GCIPL loss in glaucoma with lower intraocular pressure.
Henry Nicholas Marshall; Nicholas H Andrew; Emmanuelle Souzeau; Bronwyn Ridge; Jude Fitzgerald; Mona Awadalla; Kathryn P Burdon; Paul Healey; Ashish Agar; Anna Galanopoulos; Alex W Hewitt; Stuart Graham; John Landers; Robert James Casson; Jamie E Craig
Author Affiliations & Notes
  • Henry Nicholas Marshall
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Nicholas H Andrew
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Emmanuelle Souzeau
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Bronwyn Ridge
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Jude Fitzgerald
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Mona Awadalla
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Kathryn P Burdon
    University of Tasmania, Hobart, South Australia, Australia
  • Paul Healey
    Discipline of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
  • Ashish Agar
    University of New South Wales, Sydney, South Australia, Australia
  • Anna Galanopoulos
    Discipline of Ophthalmology & Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
  • Alex W Hewitt
    University of Tasmania, Hobart, South Australia, Australia
  • Stuart Graham
    Faculty of Medicine and Health Sciences,, Macquarie University, Sydney, New South Wales, Australia
  • John Landers
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Robert James Casson
    Discipline of Ophthalmology & Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
  • Jamie E Craig
    Department of Ophthalmology, Flinders University, North Adelaide, South Australia, Australia
  • Footnotes
    Commercial Relationships   Henry Marshall, None; Nicholas Andrew, None; Emmanuelle Souzeau, None; Bronwyn Ridge, None; Jude Fitzgerald, None; Mona Awadalla, None; Kathryn Burdon, None; Paul Healey, None; Ashish Agar, None; Anna Galanopoulos, None; Alex Hewitt, None; Stuart Graham, None; John Landers, None; Robert Casson, None; Jamie Craig, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3921. doi:
  • Views
  • Share
  • Tools
    • Alerts
      User Alerts
      You are adding an alert for:
      Peripapillary RNFL loss precedes Macular GCIPL loss in glaucoma with lower intraocular pressure.
      You will receive an email whenever this article is corrected, updated, or cited in the literature. You can manage this and all other alerts in My Account
      The alert will be sent to:
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation
      Citation

      Henry Nicholas Marshall, Nicholas H Andrew, Emmanuelle Souzeau, Bronwyn Ridge, Jude Fitzgerald, Mona Awadalla, Kathryn P Burdon, Paul Healey, Ashish Agar, Anna Galanopoulos, Alex W Hewitt, Stuart Graham, John Landers, Robert James Casson, Jamie E Craig; Peripapillary RNFL loss precedes Macular GCIPL loss in glaucoma with lower intraocular pressure.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3921.

      Download citation file:

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

      ×
    • Get Permissions
  • Supplements
Abstract

Purpose : Purpose: To investigate which clinical measures influence whether an individual demonstrates earliest glaucomatous structural progression on peripapillary retinal nerve fibre layer (pRNFL) or macular ganglion cell-inner plexiform layer (mGCIPL).

Methods : Design: Prospective longitudinal cohort study.

Participants: 271 eyes from 207 individuals with statistically significant evidence of glaucomatous progression on optical coherence tomography (OCT)-Guided Progression Analysis(GPA) software were drawn from a total of 1271 eyes from 686 individuals categorized as glaucoma suspect or having early manifest glaucoma undergoing glaucoma surveillance.

Methods: Individuals demonstrating earliest evidence of longitudinal progression on mGCIPL GPA event analysis were compared to individuals demonstrating evidence of earliest longitudinal progression on pRNFL GPA event analysis.

Results : Outcome Measures: Correlation of OCT event change analysis with intra-ocular pressure (IOP) baseline structural and baseline clinical parameters.

Results: Eyes demonstrating earliest longitudinal progression on pRNFL had a statistically significantly higher maximum-recorded pre-treatment IOP (mean difference: 3.90mmHg, 95%CI: 2.45-5.33; p<0.001) and mean IOP (mean difference 3.39; 05%CI: 2.23-4.54 p<0.001). The time interval between progression on pRNFL and progression on mGCIPL increased by 12.4 months for every 5mmHg increase in IOP (95%CI: 10.32 -15.72). Eyes with maximum-recorded pre-treatment IOP > 21.5mmHg were 3.31 (95%CI: 1.65-5.50) times more likely to progress first on pRNFL than mGCIPL. Eyes progressing first on mGCIPL parameters were 3.03 (95%CI: 1.26-7.28; p = 0.01) times more likely to develop a paracentral field defect than cases progressing first on pRNFL parameters. Eyes progressing first on pRNFL parameters were 1.79 (95%CI: 1.12-2.86; p = 0.01) times more likely to develop a peripheral field defect than cases progressing first on mGCIPL.

Conclusions : Conclusion: Pre-treatment IOP influences whether structural glaucoma progression is detected first with mGCIPL or pRNFL imaging. The results support the utility of mGCIPL imaging for detecting glaucoma progression and suggest a correlation between IOP, structural progression and functional progression.

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

 

For every increase in IOP of 5mmHg, the interval between pRNFL and mGCIPL progression increases by 12.4months. A positive value indicates pRNFL first progression
View OriginalDownload Slide

For every increase in IOP of 5mmHg, the interval between pRNFL and mGCIPL progression increases by 12.4months. A positive value indicates pRNFL first progression

For every increase in IOP of 5mmHg, the interval between pRNFL and mGCIPL progression increases by 12.4months. A positive value indicates pRNFL first progression

For every increase in IOP of 5mmHg, the interval between pRNFL and mGCIPL progression increases by 12.4months. A positive value indicates pRNFL first progression
View OriginalDownload Slide

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Attribution-NonCommercial-NoDerivatives
Copyright © 2015 Association for Research in Vision and Ophthalmology.
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×
This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy.Accept