June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Patterns of glaucomatous progression in the region of the circumpapillary retinal nerve fiber layer associated with the superior hemifield of the 24-2
Author Affiliations & Notes
  • Ha Min Kim
    Vagelos College of Physicians and Surgeons, Columbia University, New York, United States
  • Kasia Barbara Malendowicz
    Psychology, Columbia University, New York, United States
  • William Eugene McKee
    Psychology, Columbia University, New York, United States
  • Emmanouil (Manos) Tsamis
    Psychology, Columbia University, New York, United States
  • Abinaya A Thenappan
    Vagelos College of Physicians and Surgeons, Columbia University, New York, United States
  • Ashley Sun
    Psychology, Columbia University, New York, United States
  • Melvi Del Valle Eguia
    Psychology, Columbia University, New York, United States
  • Robert Ritch
    Mt. Sinai New York Eye and Ear, New York, United States
  • C Gustavo De Moraes
    Ophthalmology, Columbia University, New York, United States
  • Donald C Hood
    Psychology, Columbia University, New York, United States
    Ophthalmology, Columbia University, New York, United States
  • Footnotes
    Commercial Relationships   Ha Min Kim, None; Kasia Malendowicz, None; William McKee, None; Emmanouil (Manos) Tsamis, Topcon Inc. (R); Abinaya Thenappan, None; Ashley Sun, None; Melvi Eguia, None; Robert Ritch, None; C Gustavo De Moraes, Belite (C), Carl Zeiss (C), Galimedix (C), Heidelberg Eng (R), National Institute of Health (R), Novartis (C), Perfuse Therapeutics (C), Reichert (C), Research to Prevent Blindness (R), Topcon (R); Donald Hood, Heidelberg Eng (R), Heidelberg Eng (C), Heidelberg Eng (F), Novartis (C), Novartis (F), Topcon (C), Topcon (R), Topcon (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3927. doi:
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      Ha Min Kim, Kasia Barbara Malendowicz, William Eugene McKee, Emmanouil (Manos) Tsamis, Abinaya A Thenappan, Ashley Sun, Melvi Del Valle Eguia, Robert Ritch, C Gustavo De Moraes, Donald C Hood; Patterns of glaucomatous progression in the region of the circumpapillary retinal nerve fiber layer associated with the superior hemifield of the 24-2. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3927.

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

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Abstract

Purpose : While patterns of glaucomatous visual field (VF) progression have been characterized, [1] less is known about the patterns of OCT circumpapillary retinal nerve fiber layer (cRNFL) loss. Here we examine the rate and pattern of local cRNFL loss in a region associated with the superior hemifield of the 24-2 VF.[2]

Methods : 30 eyes of 25 patients with a diagnosis of glaucoma and evidence of progression on OCT had sdOCT disc cube scans (Topcon OCT 3000) on at least 3 separate visits. The time between the first and last visits ranged from 2.5 to 11.4 (mean 7.2±2.6) years. The enface images of disc cube scans from different sessions were aligned using blood vessels (Fig. 1A) to assure that the region of interest (ROI = 0° to -135°) of each coincided. This ROI (red in Fig. 1B) corresponds to the cRNFL associated with the superior hemifield of the 24-2 VF. The region of progression (ROP) was defined based upon the difference in cRNFL thickness between the first and subsequent visit (blue line in Fig. 1C, bottom). The locations of its leading (close to fixation) and trailing edges (blue arrows), as well as the depth of its deepest location (green arrow) were determined. Average and total loss in the ROP were also measured (hatched region, Fig. 1).

Results : On average, the ROP between the first and last visit was 89° wide, 66% of the width of the ROI, and it ranged from 40° to 134°. The ROP widening occurred both towards and away from fixation in 16 eyes, only away from fixation in 4, only towards in 8, and neither in 2. The rate of widening toward and away from fixation was comparable. The ROP of 27 of the 30 eyes also deepened at the point of maximal loss. Eyes with similar average loss (Fig. 2B), or similar remaining average thickness (Fig. 2A) in the ROI had different patterns.

Conclusions : The cRNFL loss associated with the superior 24-2 VF shows progression over a relatively wide cRNFL region and proceeds toward and away from fixation. As with VFs,[1] the abnormal region widens and deepens over time. However, progression is more complicated, as eyes with similar average cRNFL thicknesses after progression can have very different patterns of remaining cRNFL, and eyes with similar amounts of cRNFL loss during progression can have very different patterns of loss. 1. Boden et al. AJO, 2004; 2. Hood PRER, 2017.

This is a 2020 ARVO Annual Meeting abstract.

 

 

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