Original ArticleWide-field Trend-based Progression Analysis of Combined Retinal Nerve Fiber Layer and Ganglion Cell Inner Plexiform Layer Thickness: A New Paradigm to Improve Glaucoma Progression Detection
Section snippets
Subjects
A total of 236 glaucoma patients (229 patients [97.0%] with primary open-angle glaucoma; 7 patients [3.0%] with primary angle-closure glaucoma) and 49 healthy individuals were consecutively recruited from the glaucoma clinic and the general clinic in the Hong Kong Eye Hospital and the Chinese University of Hong Kong Eye Clinic between June 2015 and March 2016. Glaucoma was defined by the presence of narrowed neuroretinal rim and RNFL defects in clinical examination and OCT RNFL thickness
Trend-based Progression Analysis of RNFL-GCIPL Thickness Outperforms That of RNFL or GCIPL Thickness
A total of 5409 serial OCT images and 5345 serial VFs from 285 participants, including 440 eyes from 236 glaucoma patients and 98 eyes from 49 healthy participants who had been followed up at approximately 4-month intervals over 3.3±0.2 years (range, 3.0–3.7 years), were analyzed. Each eye had an average of 10.1 OCT scans (range, 4–13) and 9.9 VF tests (range, 4–13) for progression analysis. Table 1 compares the demographics and OCT and VF measurements between the diagnostic groups at the
Discussion
In this study, we integrate the RNFL and the GCIPL as a single layer (i.e., the RNFL-GCIPL) for progression analysis over a wide field (12×9 mm2) covering the parapapillary region and the macula, and demonstrate its importance for early detection of disease progression in glaucoma patients. With serial OCT and VF measurements obtained from 440 eyes of 236 glaucoma patients who had been followed up at ∼4-month intervals for at least 3 years, we show that progressive RNFL-GCIPL thinning often
References (21)
- et al.
Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis
Lancet Glob Health
(2017) - et al.
Combined use of retinal nerve fiber layer and ganglion cell-inner plexiform layer event-based progression analysis
Am J Ophthalmol
(2018) - et al.
Can macula and optic nerve head parameters detect glaucoma progression in eyes with advanced circumpapillary retinal nerve fiber layer damage?
Ophthalmology
(2018) - et al.
Patterns of progressive ganglion cell-inner plexiform layer thinning in glaucoma detected by OCT
Ophthalmology
(2018) - et al.
Integrating macular ganglion cell inner plexiform layer and parapapillary retinal nerve fiber layer measurements to detect glaucoma progression
Ophthalmology
(2018) - et al.
Comparing the rates of retinal nerve fiber layer and ganglion cell-inner plexiform layer loss in healthy eyes and in glaucoma eyes
Am J Ophthalmol
(2017) - et al.
Trend-based analysis of ganglion cell-inner plexiform layer thickness changes on optical coherence tomography in glaucoma progression
Ophthalmology
(2017) - et al.
Risk of visual field progression in glaucoma patients with progressive retinal nerve fiber layer thinning: a 5-year prospective study
Ophthalmology
(2016) - et al.
Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a prospective analysis of age-related loss
Ophthalmology
(2012) - et al.
Impact of age-related change of retinal nerve fiber layer and macular thicknesses on evaluation of glaucoma progression
Ophthalmology
(2013)
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Supplemental material available at www.aaojournal.org.
Financial Disclosure(s):
The authors made the following disclosures: C.L.: Speaker honorarium and research support – Carl Zeiss Meditec and Topcon; Patent – “Detection of disease-related retinal nerve fiber layer thinning” (U.S. Application No. 13/898,176); Patent license fees – Carl Zeiss Meditec.
Supported by the Hong Kong Research Grant Council General Research Fund 14101117; Topcon Research Foundation 2017–2018.
HUMAN SUBJECTS: Human subjects were included in this study. The study was conducted in accordance with the ethical standards stated in the 2013 Declaration of Helsinki, and approved by the Hong Kong Kowloon Central Research Ethics Committee, and obtained written informed consent.
No animal subjects were used in this study.
Author Contributions:
Conception and design: Leung
Data collection: Wu, Lin, Leung
Analysis and interpretation: Wu, Lin, Lam, Chan, Leung
Obtained funding: Leung
Overall responsibility: Wu, Lin, Lam, Chan, Leung
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Drs Wu and Lin contributed equally to the manuscript.