Purpose

To investigate the relationship between longitudinal changes in macular thickness measurements from OCT and changes in central visual field (VF) in patients with glaucoma with central or advanced damage at baseline.

Design

Longitudinal cohort study.

Participants

A total of 116 eyes with ≥3 years of follow-up and ≥5 macular OCT images and central 10° VF tests were selected.

Methods

OCT superpixels and VF locations were matched correcting for retinal ganglion cell (RGC) displacement. Superpixel thickness and VF total deviation (TD) values, in both logarithmic and linear scales, were averaged within 3 eccentricities (3.4°, 5.6°, and 6.8°) and superior and inferior hemiretinas and hemifields. We estimated pointwise TD rates of change and rates of change at superpixels for full macular thickness (FMT), ganglion cell complex (GCC), ganglion cell inner plexiform layer (GCIPL), and ganglion cell layer (GCL). Correlation of structure–function (SF) rates of change was investigated with parametric tests. We compared the proportion of worsening and positive slopes for superpixels and VF test locations (negative vs. positive rates of change with P < 0.05) throughout the follow-up period. Permutation analyses were used to control specificity.

Main Outcome Measures

Magnitude of correlation between structural and functional rates of change and proportion of worsening and positive slopes as a function of follow-up time.

Results

The median (interquartile range) follow-up and number of exams were 4.2 (3.7–4.6) years and 8 (7–9), respectively. The highest correlation of change rates was observed at 3.4° and 5.6° eccentricities (r = 0.24, 0.41, 0.40, and 0.40 for FMT, GCC, GCIPL, and GCL for 3.4° eccentricity and r = 0.28, 0.32, 0.31, and 0.32 for FMT, GCC, GCIPL, and GCL for 5.6° eccentricity, respectively). Although GCC measures demonstrated the highest overall longitudinal SF correlations, the differences were not statistically significant. Significant structural worsening was more frequently detected than functional deterioration at 3- and 5-year time points (P < 0.025). Permutation analyses also confirmed this finding.

Conclusions

Correlations between central structural and functional rates of change were weak to fair in this cohort. Structural changes were detected more frequently than functional changes. Measurements of both structure and function are required for optimal detection of central progression.

中文翻译：

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青光眼的纵向黄斑结构-功能关系。

目的

调查OCT的黄斑厚度测量值的纵向变化与青光眼在基线时有中枢性或晚期损害的患者之间的关系。

设计

纵向队列研究。

参加者

总共选择了116眼，进行了≥3年的随访，并且≥5眼的黄斑OCT图像和中心10°VF测试。

方法

匹配OCT超像素和VF位置，以校正视网膜神经节细胞（RGC）的位移。在对数刻度和线性刻度中，超像素厚度和VF总偏差（TD）值均在3个偏心率（3.4°，5.6°和6.8°）以及上下偏斜和半视野内取平均值。我们估算了全黄斑厚度（FMT），神经节细胞复合物（GCC），神经节细胞内部丛状层（GCIPL）和神经节细胞层（GCL）的逐点TD变化率和超像素处的变化率。使用参数测试研究了结构-功能（SF）变化率的相关性。我们比较了超级像素和VF测试位置的正斜率和正斜率的比例（P的负变化率与正变化率）<0.05）。排列分析用于控制特异性。

主要观察指标

结构和功能变化率与恶化和正斜率比例之间的相关程度随随访时间而变。

结果

中位（四分位间距）随访和检查次数分别为4.2（3.7-4.6）年和8（7-9）。观察到在3.4变化率的相关性最高°和5.6°的偏心（[R  = 0.24，0.41，0.40，和0.40为FMT，GCC，GCIPL，并且GCL为3.4°偏心和- [R  = 0.28，0.32，0.31，和0.32 FMT，GCC，GCIPL和GCL分别用于5.6°偏心距）。尽管GCC量度显示出最高的纵向SF总相关性，但差异在统计学上并不显着。在3年和5年的时间点上，相比于功能恶化，更经常发现重大的结构恶化（P <0.025）。排列分析也证实了这一发现。

结论

在这个队列中，中央结构变化和功能变化率之间的相关性是弱到公平的。检测到结构变化比功能变化更常见。需要对结构和功能进行测量，以最佳地检测中央进展。