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Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes.

Publication ,  Journal Article
Miki, A; Medeiros, FA; Weinreb, RN; Jain, S; He, F; Sharpsten, L; Khachatryan, N; Hammel, N; Liebmann, JM; Girkin, CA; Sample, PA; Zangwill, LM
Published in: Ophthalmology
July 2014

PURPOSE: To compare the rates of retinal nerve fiber layer (RNFL) loss in patients suspected of having glaucoma who developed visual field damage (VFD) with those who did not develop VFD and to determine whether the rate of RNFL loss can be used to predict the development of VFD. DESIGN: Prospective, observational cohort study. PARTICIPANTS: Glaucoma suspects, defined as having glaucomatous optic neuropathy or ocular hypertension (intraocular pressure, >21 mmHg) without repeatable VFD at baseline, from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. METHODS: Global and quadrant RNFL thickness (RNFLT) were measured with the Spectralis spectral-domain optical coherence tomography (SD-OCT; Spectralis HRA+OCT [Heidelberg Engineering, Heidelberg, Germany]). Visual field damage was defined as having 3 consecutive abnormal visual fields. The rate of RNFL loss in eyes developing VFD was compared to eyes not developing VFD using multivariate linear mixed-effects models. A joint longitudinal survival model used the estimated RNFLT slope to predict the risk of developing VFD, while adjusting for potential confounding variables. MAIN OUTCOME MEASURES: The rate of RNFL thinning and the probability of developing VFD. RESULTS: Four hundred fifty-four eyes of 294 glaucoma suspects were included. The average number of SD-OCT examinations was 4.6 (range, 2-9), with median follow-up of 2.2 years (0.4-4.1 years). Forty eyes (8.8%) developed VFD. The estimated mean rate of global RNFL loss was significantly faster in eyes that developed VFD compared with eyes that did not develop VFD (-2.02 μm/year vs. -0.82 μm/year; P<0.001). The joint longitudinal survival model showed that each 1-μm/year faster rate of global RNFL loss corresponded to a 2.05-times higher risk of developing VFD (hazard ratio, 2.05; 95% confidence interval, 1.14-3.71; P = 0.017). CONCLUSIONS: The rate of global RNFL loss was more than twice as fast in eyes that developed VFD compared with eyes that did not develop VFD. A joint longitudinal survival model showed that a 1-μm/year faster rate of RNFLT loss corresponded to a 2.05-times higher risk of developing VFD. These results suggest that measuring the rate of SD-OCT RNFL loss may be a useful tool to help identify patients who are at a high risk of developing visual field loss.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

July 2014

Volume

121

Issue

7

Start / End Page

1350 / 1358

Location

United States

Related Subject Headings

  • White People
  • Visual Fields
  • Visual Acuity
  • Vision Disorders
  • Tomography, Optical Coherence
  • Retinal Ganglion Cells
  • Prospective Studies
  • Optic Disk
  • Ophthalmology & Optometry
  • Ocular Hypertension
 

Citation

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ICMJE
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Miki, A., Medeiros, F. A., Weinreb, R. N., Jain, S., He, F., Sharpsten, L., … Zangwill, L. M. (2014). Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes. Ophthalmology, 121(7), 1350–1358. https://doi.org/10.1016/j.ophtha.2014.01.017
Miki, Atsuya, Felipe A. Medeiros, Robert N. Weinreb, Sonia Jain, Feng He, Lucie Sharpsten, Naira Khachatryan, et al. “Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes.Ophthalmology 121, no. 7 (July 2014): 1350–58. https://doi.org/10.1016/j.ophtha.2014.01.017.
Miki A, Medeiros FA, Weinreb RN, Jain S, He F, Sharpsten L, et al. Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes. Ophthalmology. 2014 Jul;121(7):1350–8.
Miki, Atsuya, et al. “Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes.Ophthalmology, vol. 121, no. 7, July 2014, pp. 1350–58. Pubmed, doi:10.1016/j.ophtha.2014.01.017.
Miki A, Medeiros FA, Weinreb RN, Jain S, He F, Sharpsten L, Khachatryan N, Hammel N, Liebmann JM, Girkin CA, Sample PA, Zangwill LM. Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes. Ophthalmology. 2014 Jul;121(7):1350–1358.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

July 2014

Volume

121

Issue

7

Start / End Page

1350 / 1358

Location

United States

Related Subject Headings

  • White People
  • Visual Fields
  • Visual Acuity
  • Vision Disorders
  • Tomography, Optical Coherence
  • Retinal Ganglion Cells
  • Prospective Studies
  • Optic Disk
  • Ophthalmology & Optometry
  • Ocular Hypertension