Abstract
Purpose :
To evaluate the effect of intraocular pressure (IOP) on the rates of macular thickness (ganglion cell layer [GCL] and ganglion cell and inner plexiform layer [GCIPL]) change over time, measured by spectral-domain optical coherence tomography (SDOCT).
Methods :
The study involved 469 eyes of 268 patients from the Duke Glaucoma Registry, a database of electronic medical records of patients with glaucoma and suspected disease followed under routine clinical care at the Duke Eye Center and satellite clinics. All records from patients with a minimum of 6 months of follow-up, at least 2 good-quality Spectralis SDOCT scans, and 2 clinical visits with Goldmann applanation tonometry were included. Rates of change for GCIPL and GCL thickness were obtained using linear mixed models.
Results :
Eyes had a mean follow-up of 2.0 ± 1.6 years. Average rate of change in GCL thickness was -0.17 ± 0.22 μm/year (median -0.17; IQR -0.27 to -0.06 μm/year) and -0.15 ± 0.36 μm/year (median -0.13; IQR -0.28 to 0.01 μm/year) in the combined GCIPL thickness. Each 1-mmHg higher mean IOP during follow-up was associated with an additional loss of -0.027 μm/year of GCL thickness (P = 0.007) and -0.048 μm/year of GCIPL thickness (P = 0.001), after adjusting for confounding factors such as baseline age, baseline thickness, sex, race, central corneal thickness and follow-up time.
Conclusions :
We quantified the effect of IOP on the rates of macular thickness thinning over time using a clinical population. Higher levels of IOP during follow-up were significantly associated with faster rates of GCL and GCIPL loss over time measured by SDOCT. These findings support the use of SDOCT GCL and GCIPL thickness measurements as biomarkers for the evaluation of the efficacy of IOP-lowering therapies.
This is a 2021 ARVO Annual Meeting abstract.