Abstract
Purpose :
To apply retinal nerve fiber (RNFL) optical texture analysis (ROTA) to investigate the pattern of RNFL defects in eyes with advanced glaucoma.
Methods :
OCT data from patients with advanced glaucoma (VF mean deviation ≤-12dB and vertical cup-dis-ratio ≥0.85) consecutively recruited from HKU Eye Centre were analysed for ROTA. All eyes underwent a comprehensive eye examination, 24-2 visual field testing (Humphrey Field Analyzer II-I, Carl Zeiss Meditec), OCT imaging of the optic disc and RNFL (Triton OCT, Topcon and Cirrus HD-OCT, Carl Zeiss Meditec) and ROTA. OCT images with a signal strength ≤6 or signal quality score ≤30 were excluded. The methodology of ROTA has been previously described (Leung CK et al., Nat Biomed Eng. 2022;6:593-604).
Results :
101 eyes from 88 subjects were included. The mean visual field mean deviation and vertical cup-to-disc ratio were -21.77dB (95%CI: -22.93~20.61) and 0.89 (95% CI: 0.89~0.90), respectively. All eyes showed RNFL defects in both superior hemiretina and inferior hemiretina. The most commonly damaged axonal fiber bundles were the superior arcuate bundle (98.0%), inferior arcuate bundle (98.0%), and inferior papillomacular bundle (98.0%), followed by the superior papillomacular bundle (89.1%), inferior papillofoveal bundle (71.3%), superior papillofoveal bundle (66.3%), and radial nasal bundle (30.1%). 32.67% of eyes showed RNFL defect involvement across the arcuate bundles, papillomacular bundles, and papillofoveal bundles.
Conclusions :
In advanced glaucoma, the superior papillofoveal bundle and the radial nasal bundle were relatively preserved compared with other axonal fiber bundles. Our study highlights that ROTA distinguished various pattern of RNFL defects in advanced glaucoma which could not be discerned from the conventional RNFL/GCIPL thickness analysis.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.