Henry N Marshall1, Nicholas H Andrew2, Mark Hassall1, Ayub Qassim1, Emmanuelle Souzeau1, Bronwyn Ridge1, Thi Nguyen1, Jude Fitzgerald1, Mona S Awadalla1, Kathryn P Burdon3, Paul R Healey4, Ashish Agar5, Anna Galanopoulos6, Alex W Hewitt7, Stuart L Graham8, John Landers1, Robert J Casson6, Jamie E Craig9. 1. Department of Ophthalmology, Flinders University, Bedford Park, Australia. 2. Department of Ophthalmology, Flinders University, Bedford Park, Australia; Discipline of Ophthalmology & Visual Sciences, The University of Adelaide, Adelaide, Australia. 3. Department of Ophthalmology, Flinders University, Bedford Park, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. 4. Discipline of Ophthalmology, University of Sydney, Sydney, Australia; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia. 5. The University of New South Wales, Sydney, New South Wales, Australia; Department of Ophthalmology, Prince of Wales Hospital, Sydney, Australia. 6. Discipline of Ophthalmology & Visual Sciences, The University of Adelaide, Adelaide, Australia. 7. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. 8. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. 9. Department of Ophthalmology, Flinders University, Bedford Park, Australia. Electronic address: jamie.craig@flinders.edu.au.
Abstract
PURPOSE: To investigate which clinical measures influence whether an individual demonstrates earliest glaucomatous structural progression on peripapillary retinal nerve fiber layer (pRNFL) or macular ganglion cell-inner plexiform layer (mGCIPL). DESIGN: Prospective, longitudinal cohort study. PARTICIPANTS: Two hundred seventy-one eyes from 207 individuals with statistically significant evidence of glaucomatous progression on OCT Guided Progression Analysis (GPA) software were drawn from a total of 1271 eyes from 686 individuals categorized as glaucoma suspect or having early manifest glaucoma undergoing glaucoma surveillance. METHODS: Individuals demonstrating earliest evidence of longitudinal progression on mGCIPL GPA event analysis were compared with individuals demonstrating evidence of earliest longitudinal progression on pRNFL GPA event analysis. MAIN OUTCOME MEASURES: Correlation of OCT event change analysis with intraocular pressure (IOP), clinical variables, and baseline thickness of the pRNFL and mGCIPL. RESULTS: Intraocular pressure, baseline pRNFL thickness, baseline mGCIPL thickness, and systemic hypertension were associated with location of first progression. Eyes demonstrating earliest longitudinal progression on mGCIPL had significantly lower maximum-recorded pretreatment IOP (mean difference, 3.90 mmHg; 95% confidence interval [CI], 2.37-5.43 mmHg; P < 0.001). The interval between progression on pRNFL and progression on mGCIPL increased by 12.4 months for every 5-mmHg increase in IOP (95% CI, 10.32-15.72 months). Eyes demonstrating earliest longitudinal progression on mGCIPL showed significantly lower baseline average pRNFL thickness than eyes progressing on pRNFL first (mean difference, 7.07 μm; 95% CI, 4.38-9.77 μm; P < 0.001). Eyes progressing first on mGCIPL parameters were 3.03 times more likely to demonstrate a new paracentral field defect than eyes progressing first on pRNFL parameters (odds ratio, 3.03; 95% CI, 1.26-7.28; P = 0.01). CONCLUSIONS: Clinical features, particularly pretreatment IOP, influence whether structural glaucoma progression is detected earlier with mGCIPL or pRNFL imaging. These data support the usefulness of mGCIPL imaging in addition to pRNFL analysis for detection of glaucoma progression, particularly in patients with normal IOP.
PURPOSE: To investigate which clinical measures influence whether an individual demonstrates earliest glaucomatous structural progression on peripapillary retinal nerve fiber layer (pRNFL) or macular ganglion cell-inner plexiform layer (mGCIPL). DESIGN: Prospective, longitudinal cohort study. PARTICIPANTS: Two hundred seventy-one eyes from 207 individuals with statistically significant evidence of glaucomatous progression on OCT Guided Progression Analysis (GPA) software were drawn from a total of 1271 eyes from 686 individuals categorized as glaucoma suspect or having early manifest glaucoma undergoing glaucoma surveillance. METHODS: Individuals demonstrating earliest evidence of longitudinal progression on mGCIPL GPA event analysis were compared with individuals demonstrating evidence of earliest longitudinal progression on pRNFL GPA event analysis. MAIN OUTCOME MEASURES: Correlation of OCT event change analysis with intraocular pressure (IOP), clinical variables, and baseline thickness of the pRNFL and mGCIPL. RESULTS:Intraocular pressure, baseline pRNFL thickness, baseline mGCIPL thickness, and systemic hypertension were associated with location of first progression. Eyes demonstrating earliest longitudinal progression on mGCIPL had significantly lower maximum-recorded pretreatment IOP (mean difference, 3.90 mmHg; 95% confidence interval [CI], 2.37-5.43 mmHg; P < 0.001). The interval between progression on pRNFL and progression on mGCIPL increased by 12.4 months for every 5-mmHg increase in IOP (95% CI, 10.32-15.72 months). Eyes demonstrating earliest longitudinal progression on mGCIPL showed significantly lower baseline average pRNFL thickness than eyes progressing on pRNFL first (mean difference, 7.07 μm; 95% CI, 4.38-9.77 μm; P < 0.001). Eyes progressing first on mGCIPL parameters were 3.03 times more likely to demonstrate a new paracentral field defect than eyes progressing first on pRNFL parameters (odds ratio, 3.03; 95% CI, 1.26-7.28; P = 0.01). CONCLUSIONS: Clinical features, particularly pretreatment IOP, influence whether structural glaucoma progression is detected earlier with mGCIPL or pRNFL imaging. These data support the usefulness of mGCIPL imaging in addition to pRNFL analysis for detection of glaucoma progression, particularly in patients with normal IOP.
Authors: Jihei Sara Lee; Hyoung Won Bae; Sungeun Park; Chan Yun Kim; Sang Yeop Lee Journal: Invest Ophthalmol Vis Sci Date: 2022-03-02 Impact factor: 4.799
Authors: Henry Marshall; Sean Mullany; Xikun Han; Ella C Berry; Mark M Hassall; Ayub Qassim; Thi Nguyen; Georgina L Hollitt; Lachlan S W Knight; Bronwyn Ridge; Joshua Schmidt; Caroline Crowley; Angela Schulz; Richard A Mills; Ashish Agar; Anna Galanopoulos; John Landers; Paul R Healey; Stuart L Graham; Alex W Hewitt; Robert J Casson; Stuart MacGregor; Owen M Siggs; Jamie E Craig Journal: Ophthalmol Sci Date: 2021-12-23