Abstract
Purpose :
To investigate the relationship between the rate of retinal nerve fiber layer (RNFL) loss during initial follow-up and the magnitude of associated visual field loss during an extended follow-up period.
Methods :
This was a retrospective cohort study. A total of 1,150 eyes of 839 glaucoma patients extracted from the Duke Glaucoma Registry. Rates of RNFL loss were obtained from global RNFL thickness values of the first 5 optical coherence tomography (OCT) scans. Rates of visual field loss were assessed using standard automated perimetry mean deviation (SAP MD) during the entire follow-up period. Joint longitudinal mixed effects models were used to estimate rates of change. Eyes were categorized as fast, moderate or slow progressors based on rates of RNFL loss, with cutoffs of ≤-2µm/y, -2 to -1µm/y and ≥-1µm/y, respectively. Univariable and multivariable regressions were completed to identify significant predictors of SAP MD loss.
Results :
The rate of RNFL change was -0.76±0.85µm/y during initial follow-up, which occurred over 3.7±1.5 years. 765 (66%) eyes were slow, 328 (29%) moderate, and 57 (5%) fast progressors, with corresponding rates of SAP MD loss of -0.16±0.35dB/y, -0.32±0.43dB/y, and -0.71±0.65dB/y over the extended follow-up period of 6.1±1.9 years (P<0.001). Age, OCT progressor group, and baseline SAP MD were all significantly associated with the rate of SAP MD loss (P<0.001).
Conclusions :
Rapid RNFL thinning during an initial follow-up period was predictive of concurrent and subsequent rates of visual field decline over an extended period. Patients with fast OCT thinning may be at high risk for developing functional disability.
This is a 2021 ARVO Annual Meeting abstract.