TY - JOUR
T1 - Retinal nerve fiber layer atrophy is associated with visual field loss over time in glaucoma suspect and glaucomatous eyes
AU - Sehi, Mitra
AU - Zhang, Xinbo
AU - Greenfield, David S.
AU - Chung, Yunsuk
AU - Wollstein, Gadi
AU - Francis, Brian A.
AU - Schuman, Joel S.
AU - Varma, Rohit
AU - Huang, David
N1 - Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest and the following were reported. Dr Greenfield has received research support from Carl Zeiss Meditec, Inc. Dr Huang has received patent royalties and grant support from Carl Zeiss Meditec . Dr Schuman receives royalties for intellectual property licensed by the Massachusetts Institute of Technology and Massachusetts Eye and Ear Infirmary to Carl Zeiss Meditec, Inc. Publication of this article was supported by Grant R01-EY013516 ( Advanced Imaging for Glaucoma Study ), Grant R01-EY013178 , Grant P30EY014801 ( University of Miami core grant), and Grant P30-EY008098 ( University of Pittsburgh core grant) from the National Institutes of Health , Bethesda, Maryland; and by an unrestricted grant from Research to Prevent Blindness, Inc , New York, New York. ClinicalTrials.gov identifier: NCT01314326 . Involved in Design of study (M.S., D.S.G., X.Z., D.H.); Conduct of study (M.S., Y.S.C., D.S.G., X.Z., G.W., B.A.F., J.S.S., R.V., D.H.); Collection of data (M.S., Y.S.C., D.S.G., X.Z., G.W., B.A.F., J.S.S., R.V., D.H.); Management of data (M.S., Y.S.C., D.S.G., X.Z., G.W., B.A.F., J.S.S., R.V., D.H.); Analysis of data (M.S., D.S.G., X.Z., D.H.); Interpretation of data (M.S., D.S.G., X.Z., J.S.S., R.V., D.H.); Preparation of manuscript (M.S., D.S.G., X.Z.); Review and approval of manuscript (M.S., Y.S.C., D.S.G., X.Z., G.W., B.A.F., J.S.S., R.V., D.H.). The institutional review boards (IRB) of all universities involved in this study approved the entire Advanced Imaging for Glaucoma Study protocol before the commencement of the study. Informed consent was obtained from all subjects using the consent forms approved by the IRBs of the participating institutions, which were in agreement with the provisions of Declaration of Helsinki. The study was in accordance with The Health Insurance Portability and Accountability Act of 1996 privacy and security regulations.
PY - 2013/1
Y1 - 2013/1
N2 - Purpose: To compare prospectively detection of progressive retinal nerve fiber layer thickness (RNFL) atrophy identified using time-domain optical coherence tomography with visual field progression using standard automated perimetry in glaucoma suspect and preperimetric glaucoma patients or perimetric glaucoma patients. Design: Prospective, longitudinal clinical trial. Methods: Eligible eyes with 2 years or more of follow-up underwent time-domain optical coherence tomography and standard automated perimetry every 6 months. The occurrence of visual field progression was defined as the first follow-up visit reaching a significant (P <.05) negative visual field index slope over time. RNFL progression or improvement was defined as a significant negative or positive slope over time, respectively. Specificity was defined as the number of eyes with neither progression nor improvement, divided by the number of eyes without progression. Cox proportional hazard ratios were calculated using univariate and multivariate models with RNFL loss as a time-dependent covariate. Results: Three hundred ten glaucoma suspect and preperimetric glaucoma eyes and 177 perimetric glaucoma eyes were included. Eighty-nine eyes showed visual field progression and 101 eyes showed RNFL progression. The average time to detect visual field progression in those 89 eyes was 35 ± 13 months, and the average time to detect RNFL progression in those 101 eyes was 36 ± 13 months. In multivariate Cox models, average and superior RNFL losses were associated with subsequent visual field index loss in the entire cohort (every 10-μm loss; hazard ratio, 1.38; P =.03; hazard ratio, 1.20; P =.01; respectively). Among the entire cohort of 487 eyes, 42 had significant visual field index improvement and 55 had significant RNFL improvement (specificity, 91.4% and 88.7%, respectively). Conclusions: Structural progression is associated with functional progression in glaucoma suspect and glaucomatous eyes. Average and superior RNFL thickness may predict subsequent standard automated perimetry loss.
AB - Purpose: To compare prospectively detection of progressive retinal nerve fiber layer thickness (RNFL) atrophy identified using time-domain optical coherence tomography with visual field progression using standard automated perimetry in glaucoma suspect and preperimetric glaucoma patients or perimetric glaucoma patients. Design: Prospective, longitudinal clinical trial. Methods: Eligible eyes with 2 years or more of follow-up underwent time-domain optical coherence tomography and standard automated perimetry every 6 months. The occurrence of visual field progression was defined as the first follow-up visit reaching a significant (P <.05) negative visual field index slope over time. RNFL progression or improvement was defined as a significant negative or positive slope over time, respectively. Specificity was defined as the number of eyes with neither progression nor improvement, divided by the number of eyes without progression. Cox proportional hazard ratios were calculated using univariate and multivariate models with RNFL loss as a time-dependent covariate. Results: Three hundred ten glaucoma suspect and preperimetric glaucoma eyes and 177 perimetric glaucoma eyes were included. Eighty-nine eyes showed visual field progression and 101 eyes showed RNFL progression. The average time to detect visual field progression in those 89 eyes was 35 ± 13 months, and the average time to detect RNFL progression in those 101 eyes was 36 ± 13 months. In multivariate Cox models, average and superior RNFL losses were associated with subsequent visual field index loss in the entire cohort (every 10-μm loss; hazard ratio, 1.38; P =.03; hazard ratio, 1.20; P =.01; respectively). Among the entire cohort of 487 eyes, 42 had significant visual field index improvement and 55 had significant RNFL improvement (specificity, 91.4% and 88.7%, respectively). Conclusions: Structural progression is associated with functional progression in glaucoma suspect and glaucomatous eyes. Average and superior RNFL thickness may predict subsequent standard automated perimetry loss.
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U2 - 10.1016/j.ajo.2012.07.005
DO - 10.1016/j.ajo.2012.07.005
M3 - Article
C2 - 23036570
AN - SCOPUS:84871256821
SN - 0002-9394
VL - 155
SP - 73-82.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 1
ER -