July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Comparison of Macular and RNFL Rates of Progression in Eyes with Advanced Glaucoma
Author Affiliations & Notes
  • Anne L Coleman
    Jules Stein Eye Institute, UCLA, Santa Monica, California, United States
  • Alessandro Rabiolo
    Jules Stein Eye Institute, UCLA, Santa Monica, California, United States
  • Vahid Mohammadzadeh
    Jules Stein Eye Institute, UCLA, Santa Monica, California, United States
  • Simon K. Law
    Jules Stein Eye Institute, UCLA, Santa Monica, California, United States
  • Joseph Caprioli
    Jules Stein Eye Institute, UCLA, Santa Monica, California, United States
  • Kouros Nouri-Mahdavi
    Jules Stein Eye Institute, UCLA, Santa Monica, California, United States
  • Footnotes
    Commercial Relationships   Anne Coleman, None; Alessandro Rabiolo, None; Vahid Mohammadzadeh, None; Simon Law, None; Joseph Caprioli, None; Kouros Nouri-Mahdavi, None
  • Footnotes
    Support  supported by a Departmental grant from Research to Prevent Blindness and an unrestricted grant from Heidelberg Engineering
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5602. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Anne L Coleman, Alessandro Rabiolo, Vahid Mohammadzadeh, Simon K. Law, Joseph Caprioli, Kouros Nouri-Mahdavi; Comparison of Macular and RNFL Rates of Progression in Eyes with Advanced Glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5602.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : To compare OCT-derived macular and RNFL rates of changes in glaucoma eyes with evidence of central or advanced damage as a function of baseline glaucoma severity.

Methods : 106 eyes (106 patients) from UCLA’s Advanced Glaucoma Progression Study with ≥2 years of follow-up and ≥5 OCT exams and visual fields (VF) were included. Rates of structural change were estimated by regressing the thickness of outcomes of interest vs. time. To facilitate fair comparison of rates of change, normalized rates were calculated by dividing rates of change by the standard deviation of the regression residuals. Outcomes of interests were global and sectoral (Figure 1) rates of change for full macular thickness (FMT), macular ganglion cell/inner plexiform layer (mGCIPL), and peripapillary RNFL (pRNFL). Rates of change and proportion of worsening and improving sectors (at p<0.05) were compared among the structural outcomes. Analyses were stratified based on 24-2 VF progression status at final follow-up according to pointwise linear regression. Variations in rates of change as a function of baseline thickness were explored.

Results : The median (IQR) baseline VF mean deviation, follow-up time, and number of tests were –6.7 (–12.3 to –4.3) dB, 4.5 (4.1-5.0) years, and 9 (8-10), respectively. The FMT macular sector corresponding to papillomacular bundle (sector D) had the fastest normalized rates of change than most other parameters (p<0.05) followed by rates in pRNFL inferonasal sector (p=0.08), mGCIPL sector D (p=0.10), and global FMT (p=0.13). The FMT macular sector D had also the highest detection rates (62.3%) and lowest false discovery rate (0.0%), followed by FMT global thickness and pRNFL global thickness. Overall, detection rates were highest for FMT, followed by pRNFL and mGCIPL outcomes with a larger difference among the 3 with decreasing baseline thickness. Normalized rates of change were faster in patients with VF progression only for FMT sector F (p=0.03), and mGCIPL sectors C (p=0.046) and F (p=0.02).

Conclusions : FMT measurements had the best performance for detection of change across the spectrum of disease severity with the papillomacular bundle sector most likely to detect worsening with lowest false discovery rate. GCIPL was not superior to pRNFL in this cohort. Our findings confirm the utility of FMT measures in more severe stages of glaucoma.

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

 

 

×
×

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.

×