June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Rates of RNFL thinning in distinct glaucomatous optic disc phenotypes in early glaucoma
Ryan Caezar Calaguas David; Sasan Moghimi; Eren Ekici; Jiun Lap Do; Huiyuan Hou; James A Proudfoot; Alireza Kamalipour; Takashi Nishida; Christopher A Girkin; Jeffrey M Liebmann; Robert N Weinreb
Author Affiliations & Notes
  • Ryan Caezar Calaguas David
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Sasan Moghimi
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Eren Ekici
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Jiun Lap Do
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Huiyuan Hou
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • James A Proudfoot
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Alireza Kamalipour
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Takashi Nishida
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Christopher A Girkin
    Department of Ophthalmology and Visual Sciences, UAB Callahan Eye Hospital, Birmingham, Alabama, United States
  • Jeffrey M Liebmann
    Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York, United States
  • Robert N Weinreb
    Hamilton Glaucoma Center, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Ryan Caezar David, None; Sasan Moghimi, None; Eren Ekici, None; Jiun Do, None; Huiyuan Hou, None; James Proudfoot, None; Alireza Kamalipour, None; Takashi Nishida, None; Christopher Girkin, Carl Zeiss Meditec (F), Heidelberg Engineering (F); Jeffrey Liebmann, Alcon (C), Allergan (C), Bausch & Lomb (F), Bausch & Lomb (C), Carl Zeiss Meditec (C), Carl Zeiss Meditec (F), Heidelberg Engineering (F), Heidelberg Engineering (C), Optovue (F), Reichert (F), Reichert (C), Topcon (F), Valeant Pharmaceuticals (C); Robert Weinreb, Aerie Pharmaceuticals (C), Allergan (C), Bausch&Lomb (C), Bausch&Lomb (F), Carl Zeiss Meditec (F), Centervue (F), Eyenovia (C), Genentech (F), Heidelberg Engineering (F), Konan Medical (F), Meditec-Zeiss (P), Optos (F), Optovue (F), Toromedes (P), Unity (C)
  • Footnotes
    Support  P30EY022589, UCSD School of Medicine Summer Research Fellowship, Eyesight Foundation of Alabama; Alcon Laboratories Inc.; Allergan Inc.; Pfizer Inc.; Merck Inc.; Santen Inc.; and the Edith C. Blum Research Fund of the New York Glaucoma Research Institute, New York, NY, Unrestricted grant from Research to Prevent Blindness, New York, New York, NEI Grant No. EY026574, EY010427, EY029058, Tobacco-Related Disease Research Program T31IP1511, K12 Career Development Grant - NEI
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1832. doi:
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      Ryan Caezar Calaguas David, Sasan Moghimi, Eren Ekici, Jiun Lap Do, Huiyuan Hou, James A Proudfoot, Alireza Kamalipour, Takashi Nishida, Christopher A Girkin, Jeffrey M Liebmann, Robert N Weinreb; Rates of RNFL thinning in distinct glaucomatous optic disc phenotypes in early glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1832.

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Abstract

Purpose : To compare spectral-domain optical coherence tomography (SDOCT) measured circumpapillary retinal nerve fiber layer (cpRNFL) among four glaucomatous optic disc phenotypes in early glaucoma.

Methods : In this longitudinal study, 218 early glaucoma eyes that had at least 3 years of follow-up and a minimum of 4 SDOCT scans were recruited from the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). The optic discs were classified into four types based on appearance: generalized cup enlargement (GE), focal ischemic (FI), myopic glaucomatous (MY), and senile sclerotic (SS). A linear mixed-effect model was used to compare the rates of global and regional cpRNFL thinning among optic disc phenotypes.

Results : Of the 218 early glaucoma eyes that were followed for an average of 5.9 years, 76 were classified as generalized cup enlargement (GE), 53 focal ischemic (FI), 22 myopic glaucomatous (MY), and 67 senile sclerotic (SS) discs. After adjusting for confounders, the SS group (mean (95% CI): -1.01 (-1.30, -0.73) µm/year) had the fastest mean rate of global cpRNFL thinning followed by FI (-0.77 (-0.97, -0.57) µm/year), MY (0.59 (-0.81, -0.36) µm/year) and GE (-0.58 (-0.75, -0.40) µm/year) at p<0.001. The inferior temporal sector had the fastest mean rate of cpRNFL thinning among the regional measurements except for the MY group (-0.68 (-1.10, -0.26) µm/year), p=0.002). In the multivariable analysis, higher mean intraocular pressure during follow-up (p<0.001) and optic disc phenotype (p=0.014) were associated with faster cpRNFL thinning. The GE (p=0.002) and MY (p=0.010 ) phenotypes were associated with significantly slower global rates of cpRNFL thinning when compared to the SS phenotype.

Conclusions : Rates of cpRNFL thinning were different among the four glaucomatous optic disc phenotypes. Those patients with early glaucoma with SS phenotype have the fastest cpRNFL thinning. These patients may benefit from more frequent monitoring and the need to advance therapy if cpRNFL thinning is detected.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure 1. Diagrams showing estimated mean rates of circumpapillary retinal nerve fiber layer (cpRNFL) thinning for generalized cup enlargement (GE), focal ischemic (FI), myopic glaucomatous (MY) and senile sclerotic (SS) eyes in early glaucoma (24-2 VF MD>-6 dB). Data are presented as cpRNFL change rate (µm/year).
View OriginalDownload Slide

Figure 1. Diagrams showing estimated mean rates of circumpapillary retinal nerve fiber layer (cpRNFL) thinning for generalized cup enlargement (GE), focal ischemic (FI), myopic glaucomatous (MY) and senile sclerotic (SS) eyes in early glaucoma (24-2 VF MD>-6 dB). Data are presented as cpRNFL change rate (µm/year).

Figure 1. Diagrams showing estimated mean rates of circumpapillary retinal nerve fiber layer (cpRNFL) thinning for generalized cup enlargement (GE), focal ischemic (FI), myopic glaucomatous (MY) and senile sclerotic (SS) eyes in early glaucoma (24-2 VF MD>-6 dB). Data are presented as cpRNFL change rate (µm/year).

Figure 1. Diagrams showing estimated mean rates of circumpapillary retinal nerve fiber layer (cpRNFL) thinning for generalized cup enlargement (GE), focal ischemic (FI), myopic glaucomatous (MY) and senile sclerotic (SS) eyes in early glaucoma (24-2 VF MD>-6 dB). Data are presented as cpRNFL change rate (µm/year).
View OriginalDownload Slide

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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Copyright © 2024 Association for Research in Vision and Ophthalmology.
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