Alberto Diniz-Filho1, Ricardo Y Abe2, Linda M Zangwill2, Carolina P B Gracitelli3, Robert N Weinreb2, Christopher A Girkin4, Jeffrey M Liebmann5, Felipe A Medeiros6. 1. Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California; Department of Ophthalmology and Otorhinolaryngology, Federal University of Minas Gerais, Belo Horizonte, Brazil. 2. Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California. 3. Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California; Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. 4. Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama. 5. Harkness Eye Institute, Columbia University Medical Center, New York, New York. 6. Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California. Electronic address: fmedeiros@ucsd.edu.
Abstract
PURPOSE: To evaluate the relationship between intraocular pressure (IOP) and rates of retinal nerve fiber layer (RNFL) thickness change over time measured by spectral-domain (SD) optical coherence tomography (OCT). DESIGN: Observational cohort study. PARTICIPANTS: The study involved 547 eyes of 339 patients followed up for an average of 3.9±0.9 years. Three hundred eight (56.3%) had a diagnosis of glaucoma and 239 (43.7%) were considered glaucoma suspects. METHODS: All eyes underwent imaging using the Spectralis SD OCT (Heidelberg Engineering GmbH, Heidelberg, Germany), along with IOP measurements and standard automated perimetry (SAP). Glaucoma progression was defined as a result of "Likely Progression" from the Guided Progression Analysis software for SAP. Linear mixed models were used to investigate the relationship between average IOP during follow-up and rates of RNFL thickness change, while taking into account potential confounding factors such as age, race, corneal thickness, and baseline disease severity. MAIN OUTCOME MEASURES: The association between IOP and rates of global and sectorial RNFL thickness loss measured by SD OCT. RESULTS: Forty-six eyes (8.4%) showed progression on SAP during follow-up. Rates of global RNFL thickness change in eyes that progressed by SAP were faster than in those that did not progress (-1.02 vs. -0.61 μm/year, respectively; P = 0.002). For progressing eyes, each 1-mmHg higher average in IOP during follow-up was associated with an additional average loss of 0.20 μm/year (95% confidence interval [CI]: 0.08 to 0.31 μm/year; P < 0.001) of global RNFL thickness versus only 0.04 μm/year (95% CI: 0.01 to 0.07 μm/year; P = 0.015) for nonprogressing eyes. The largest associations between IOP and rates of RNFL change were seen for measurements from the temporal superior and temporal inferior sectors, whereas the smallest association was seen for measurements from the nasal sector. CONCLUSIONS: Higher levels of IOP during follow-up were associated with faster rates of RNFL loss over time measured by SD OCT. These findings support the use of SD OCT RNFL thickness measurements as biomarkers for the evaluation of the efficacy of IOP-lowering therapies to slow down the rate of disease progression.
PURPOSE: To evaluate the relationship between intraocular pressure (IOP) and rates of retinal nerve fiber layer (RNFL) thickness change over time measured by spectral-domain (SD) optical coherence tomography (OCT). DESIGN: Observational cohort study. PARTICIPANTS: The study involved 547 eyes of 339 patients followed up for an average of 3.9±0.9 years. Three hundred eight (56.3%) had a diagnosis of glaucoma and 239 (43.7%) were considered glaucoma suspects. METHODS: All eyes underwent imaging using the Spectralis SD OCT (Heidelberg Engineering GmbH, Heidelberg, Germany), along with IOP measurements and standard automated perimetry (SAP). Glaucoma progression was defined as a result of "Likely Progression" from the Guided Progression Analysis software for SAP. Linear mixed models were used to investigate the relationship between average IOP during follow-up and rates of RNFL thickness change, while taking into account potential confounding factors such as age, race, corneal thickness, and baseline disease severity. MAIN OUTCOME MEASURES: The association between IOP and rates of global and sectorial RNFL thickness loss measured by SD OCT. RESULTS: Forty-six eyes (8.4%) showed progression on SAP during follow-up. Rates of global RNFL thickness change in eyes that progressed by SAP were faster than in those that did not progress (-1.02 vs. -0.61 μm/year, respectively; P = 0.002). For progressing eyes, each 1-mmHg higher average in IOP during follow-up was associated with an additional average loss of 0.20 μm/year (95% confidence interval [CI]: 0.08 to 0.31 μm/year; P < 0.001) of global RNFL thickness versus only 0.04 μm/year (95% CI: 0.01 to 0.07 μm/year; P = 0.015) for nonprogressing eyes. The largest associations between IOP and rates of RNFL change were seen for measurements from the temporal superior and temporal inferior sectors, whereas the smallest association was seen for measurements from the nasal sector. CONCLUSIONS: Higher levels of IOP during follow-up were associated with faster rates of RNFL loss over time measured by SD OCT. These findings support the use of SD OCT RNFL thickness measurements as biomarkers for the evaluation of the efficacy of IOP-lowering therapies to slow down the rate of disease progression.
Authors: Felipe A Medeiros; Linda M Zangwill; Luciana M Alencar; Pamela A Sample; Robert N Weinreb Journal: Am J Ophthalmol Date: 2010-04-08 Impact factor: 5.258
Authors: Carolina P B Gracitelli; Ricardo Y Abe; Andrew J Tatham; Peter N Rosen; Linda M Zangwill; Erwin R Boer; Robert N Weinreb; Felipe A Medeiros Journal: JAMA Ophthalmol Date: 2015-04 Impact factor: 7.389
Authors: Christopher K S Leung; Marco Yu; Robert N Weinreb; Cong Ye; Shu Liu; Gilda Lai; Dennis S C Lam Journal: Ophthalmology Date: 2012-01-20 Impact factor: 12.079
Authors: Felipe A Medeiros; Linda M Zangwill; Christopher Bowd; Roberto M Vessani; Remo Susanna; Robert N Weinreb Journal: Am J Ophthalmol Date: 2005-01 Impact factor: 5.258
Authors: Felipe A Medeiros; Carolina P B Gracitelli; Erwin R Boer; Robert N Weinreb; Linda M Zangwill; Peter N Rosen Journal: Ophthalmology Date: 2014-10-16 Impact factor: 12.079
Authors: Ting Liu; Andrew J Tatham; Carolina P B Gracitelli; Linda M Zangwill; Robert N Weinreb; Felipe A Medeiros Journal: Ophthalmology Date: 2015-09-15 Impact factor: 12.079
Authors: Delia Bendschneider; Ralf P Tornow; Folkert K Horn; Robert Laemmer; Christopher W Roessler; Anselm G Juenemann; Friedrich E Kruse; Christian Y Mardin Journal: J Glaucoma Date: 2010-09 Impact factor: 2.503
Authors: Felipe A Medeiros; Luciana M Alencar; Linda M Zangwill; Christopher Bowd; Gianmarco Vizzeri; Pamela A Sample; Robert N Weinreb Journal: Invest Ophthalmol Vis Sci Date: 2008-11-21 Impact factor: 4.799
Authors: Huiyuan Hou; Sasan Moghimi; Linda M Zangwill; James A Proudfoot; Tadamichi Akagi; Takuhei Shoji; Christopher A Girkin; Jeffrey M Liebmann; Robert N Weinreb Journal: Ophthalmol Glaucoma Date: 2019-11-14
Authors: Aakriti G Shukla; C Gustavo De Moraes; George A Cioffi; Christopher A Girkin; Robert N Weinreb; Linda M Zangwill; Jeffrey M Liebmann Journal: J Glaucoma Date: 2020-06 Impact factor: 2.503
Authors: Alessandro A Jammal; Atalie C Thompson; Eduardo B Mariottoni; Tais Estrela; Leonardo S Shigueoka; Samuel I Berchuck; Felipe A Medeiros Journal: Ophthalmology Date: 2020-06-21 Impact factor: 12.079
Authors: Sharon Y L Chua; Gerassimos Lascaratos; Denize Atan; Bing Zhang; Charles Reisman; Peng T Khaw; Stephen M Smith; Paul M Matthews; Axel Petzold; Nicholas G Strouthidis; Paul J Foster; Anthony P Khawaja; Praveen J Patel Journal: Eur J Neurol Date: 2021-01-20 Impact factor: 6.089
Authors: Ryan Caezar C David; Sasan Moghimi; Eren Ekici; Jiun L Do; Huiyuan Hou; James A Proudfoot; Alireza Kamalipour; Takashi Nishida; Christopher A Girkin; Jeffrey M Liebmann; Robert N Weinreb Journal: Am J Ophthalmol Date: 2021-04-25 Impact factor: 5.488
Authors: Swarup S Swaminathan; Alessandro A Jammal; Samuel I Berchuck; Felipe A Medeiros Journal: Am J Ophthalmol Date: 2021-03-26 Impact factor: 5.488
Authors: Harsha L Rao; Srilakshmi Dasari; Narendra K Puttaiah; Zia S Pradhan; Sasan Moghimi; Kaweh Mansouri; Carroll A B Webers; Robert N Weinreb Journal: Am J Ophthalmol Date: 2021-07-25 Impact factor: 5.258
Authors: Ha Min Kim; William E McKee; Katarzyna B Malendowicz; Abinaya A Thenappan; Emmanouil Tsamis; Melvi D Eguia; C Gustavo De Moraes; Robert Ritch; Donald C Hood Journal: J Glaucoma Date: 2020-10 Impact factor: 2.290