PRECIS: The region of glaucomatous progression, seen on optical coherence tomography (OCT) images of the circumpapillary retinal nerve fiber layer (cRNFL), increases in width and depth in all eyes, but shows a variety of different patterns of loss across eyes. PURPOSE: The purpose of this study was to examine the patterns of cRNFL loss secondary to glaucomatous progression in a region associated with the superior hemifield of the 24-2/30-2 visual field (VF). METHODS: Twenty-four eyes (20 patients) with a diagnosis of glaucoma and evidence of progression on OCT had OCT disc cube scans on at least 3 separate visits (mean follow-up 7.4 y; range: 3.9 to 11.4). Circumpapillary b-scans were derived after enface images were aligned to assure that the study region (ie, 0 to -135 degrees, where 0 degree is 9 o'clock, on a right eye) coincided. Within this region, a region of progression (ROP) was defined based on the loss in cRNFL thickness between the first and subsequent visits. The width of the ROP was determined, along with the locations of its leading (close to fixation) and trailing edges. In addition, for each ROP, the location and depth at the point of maximal loss, total loss, and average remaining retinal nerve fiber layer were measured. RESULTS: The ROP proceeded both toward and away from fixation. Across eyes, the ROP varied widely in width (32 to 131 degrees, mean 82.7 degrees), location, and loss at point of deepest loss (22 to 99 μm, mean 52.9 μm), as well as total cRNFL loss. CONCLUSIONS: All eyes showed a widening and deepening of the ROP, but a variety of different patterns of progressive cRNFL loss. Thus, one should expect considerable variation in patterns of VF loss. Furthermore, conventional metrics (global or quadrant cRNFL thickness) do not fully depict the progressive changes that can be appreciated by inspecting OCT images.
PRECIS: The region of glaucomatous progression, seen on optical coherence tomography (OCT) images of the circumpapillary retinal nerve fiber layer (cRNFL), increases in width and depth in all eyes, but shows a variety of different patterns of loss across eyes. PURPOSE: The purpose of this study was to examine the patterns of cRNFL loss secondary to glaucomatous progression in a region associated with the superior hemifield of the 24-2/30-2 visual field (VF). METHODS: Twenty-four eyes (20 patients) with a diagnosis of glaucoma and evidence of progression on OCT had OCT disc cube scans on at least 3 separate visits (mean follow-up 7.4 y; range: 3.9 to 11.4). Circumpapillary b-scans were derived after enface images were aligned to assure that the study region (ie, 0 to -135 degrees, where 0 degree is 9 o'clock, on a right eye) coincided. Within this region, a region of progression (ROP) was defined based on the loss in cRNFL thickness between the first and subsequent visits. The width of the ROP was determined, along with the locations of its leading (close to fixation) and trailing edges. In addition, for each ROP, the location and depth at the point of maximal loss, total loss, and average remaining retinal nerve fiber layer were measured. RESULTS: The ROP proceeded both toward and away from fixation. Across eyes, the ROP varied widely in width (32 to 131 degrees, mean 82.7 degrees), location, and loss at point of deepest loss (22 to 99 μm, mean 52.9 μm), as well as total cRNFL loss. CONCLUSIONS: All eyes showed a widening and deepening of the ROP, but a variety of different patterns of progressive cRNFL loss. Thus, one should expect considerable variation in patterns of VF loss. Furthermore, conventional metrics (global or quadrant cRNFL thickness) do not fully depict the progressive changes that can be appreciated by inspecting OCT images.
Authors: Mary Lucy M Pereira; Chang-Sik Kim; M Bridget Zimmerman; Wallace L M Alward; Sohan S Hayreh; Young H Kwon Journal: Ophthalmology Date: 2002-12 Impact factor: 12.079
Authors: Donald C Hood; Diane L Wang; Ali S Raza; Carlos Gustavo de Moraes; Jeffrey M Liebmann; Robert Ritch Journal: Invest Ophthalmol Vis Sci Date: 2013-11-08 Impact factor: 4.799
Authors: Naama Hammel; Akram Belghith; Robert N Weinreb; Felipe A Medeiros; Nadia Mendoza; Linda M Zangwill Journal: Am J Ophthalmol Date: 2017-03-16 Impact factor: 5.258
Authors: Bianca N Susanna; Nara G Ogata; Fábio B Daga; Carolina N Susanna; Alberto Diniz-Filho; Felipe A Medeiros Journal: Ophthalmology Date: 2018-08-13 Impact factor: 12.079
Authors: Donald C Hood; Brad Fortune; Stella N Arthur; Danli Xing; Jennifer A Salant; Robert Ritch; Jeffrey M Liebmann Journal: J Glaucoma Date: 2008 Oct-Nov Impact factor: 2.503
Authors: Atsuya Miki; Felipe A Medeiros; Robert N Weinreb; Sonia Jain; Feng He; Lucie Sharpsten; Naira Khachatryan; Na'ama Hammel; Jeffrey M Liebmann; Christopher A Girkin; Pamela A Sample; Linda M Zangwill Journal: Ophthalmology Date: 2014-03-13 Impact factor: 12.079