Abstract
Purpose :
To assess the use of risk scores that are solely derived from swept-source optical coherence tomography(OCT) measurements to predict the development of perimetric glaucoma in suspect eyes.
Methods :
Longitudinal data were collected from 101 healthy eyes and 269 glaucoma suspect eyes who had a baseline OCT scan within 6 months of semiannual visual field(VF) follow-up. Glaucoma suspect was defined as optic disc appeared suspicious of glaucoma and/or had high intraocular pressure(IOP), but without evidence of repeatable glaucomatous VF damage. OCT-based(DRI OCT Triton, Topcon) macular and peripapillary inner retinal layer thickness measurements were obtained from the baseline wide scan(12mmx9mm). Four OCT-based risk scores for each eye were generated from the measurement segments and grids in the OCT reports. VF conversion during the follow-up was defined as two successive VFs with glaucoma hemifield test results outside normal limits and/or pattern standard deviation outside 95% normal limit. A Cox proportional hazards ratio model was used to evaluate predictors at baseline including the risk scores and individual OCT thickness metrics. Age, gender, race, IOP, and central corneal thickness(CCT) were adjusted as possible confounders.
Results :
The mean(95% confidence interval) follow-up time from baseline OCT was 2.89(2.66, 3.12) years. Ninety-two(24.86%) eyes developed perimetric glaucoma during the follow-up. Age, CCT, global circumpapillary retinal nerve fiber layer(RNFL) thickness, ganglion cell complex(GCC) thickness, ganglion cell–inner plexiform layer(GCIPL) thickness and the four OCT-based risk scores had a significant hazard ratio(HR) in both univariable and multivariable models. The risk of developing perimetric glaucoma decreased with thicker baseline CCT, RNFL, GCC and GCIPL with HR of 0.99, 0.97, 0.95, and 0.94, respectively, and increased with older age(HR 1.04) and higher baseline risk scores. Every 10 points increase of the OCT-based risk scores from the four models led to 1.19-1.25 folds of increased risk of developing glaucoma.(Table)
Conclusions :
OCT-based risk scores, which combine peripapillary RNFL and macular thickness measurements, can be used to predict eyes at risk for developing perimetric glaucoma, indicating risk scores solely derived from OCT could be used to identify suspects who require more frequent monitoring.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.