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Invest Ophthalmol Vis SciFebruary 20190 citations

Rates of Ganglion Cell-Inner Plexiform Layer Thinning in Normal, Open-Angle Glaucoma and Pseudoexfoliation Glaucoma Eyes: A Trend-Based Analysis.

Lee Won June, Baek Sung Uk, Kim Young Kook, Park Ki Ho, Jeoung Jin Wook


AI Summary

This study found pseudoexfoliation glaucoma (PXG) causes significantly faster retinal nerve fiber layer thinning than open-angle glaucoma or normal eyes, highlighting PXG's aggressive progression.

Abstract

Purpose

The purpose of this study was to determine the rate of ganglion cell-inner plexiform layer (GCIPL) thinning by Cirrus high-definition optical coherence tomography (HD-OCT) in normal eyes and open-angle glaucoma (OAG) and pseudoexfoliation glaucoma (PXG) eyes.

Methods

This was a longitudinal observational study. We evaluated 282 subjects who visited a glaucoma clinic of a tertiary hospital in Korea: 60 healthy eyes, 193 medically treated OAG eyes, and 29 medically treated PXG eyes with a minimum 3-year follow-up involving serial spectral-domain OCT measurement of GCIPL thickness. The rates of thinning in the GCIPL thickness of the global region, six macular sectors, and minimum thickness were determined by linear mixed model and compared among the normal, OAG, and PXG groups. Additionally, the GCIPL thinning rates were compared between normal-baseline-IOP OAG (normal-tension glaucoma [NTG]) and high-baseline-IOP OAG (high-tension glaucoma [HTG]) eyes.

Results

The mean rates of GCIPL thinning were -0.31 μm/y in the normal eyes, -0.49 μm/y in OAG, and -1.46 μm/y in PXG. The differences in the mean GCIPL thinning rates were statistically significant between OAG and PXG (normal versus OAG, P = 0.231; OAG versus PXG, P < 0.001; normal versus PXG, P < 0.001). Among the eyes with OAG, the treated NTG and HTG eyes showed no significant difference in GCIPL thinning rate (NTG versus HTG = -0.41 μm/y versus -0.66 μm/y, P = 0.123).

Conclusions

We determined the GCIPL thinning rates for normal and undertreated OAG and PXG eyes. Differences existed among the normal eyes and glaucoma types, with PXG progressing significantly faster than OAG.


MeSH Terms

AdultAgedExfoliation SyndromeFemaleGlaucoma, Open-AngleGonioscopyHealthy VolunteersHumansIntraocular PressureLongitudinal StudiesMaleMiddle AgedNerve FibersRetinal Ganglion CellsTomography, Optical CoherenceVisual AcuityVisual Fields

Key Concepts4

The mean rate of ganglion cell-inner plexiform layer (GCIPL) thinning was -0.31 μm/y in normal eyes, -0.49 μm/y in open-angle glaucoma (OAG) eyes, and -1.46 μm/y in pseudoexfoliation glaucoma (PXG) eyes, as measured by Cirrus high-definition optical coherence tomography (HD-OCT).

PrognosisCohortLongitudinal Observational Studyn=60 healthy eyes, 193 medically treate…Ch5Ch12Ch16

The differences in the mean ganglion cell-inner plexiform layer (GCIPL) thinning rates were statistically significant between open-angle glaucoma (OAG) and pseudoexfoliation glaucoma (PXG) (P < 0.001), and between normal eyes and PXG (P < 0.001), but not between normal eyes and OAG (P = 0.231).

Comparative EffectivenessCohortLongitudinal Observational Studyn=60 healthy eyes, 193 medically treate…Ch5Ch12Ch16

Among eyes with open-angle glaucoma (OAG), medically treated normal-tension glaucoma (NTG) eyes showed a mean ganglion cell-inner plexiform layer (GCIPL) thinning rate of -0.41 μm/y, and medically treated high-tension glaucoma (HTG) eyes showed a mean GCIPL thinning rate of -0.66 μm/y, with no significant difference between the two groups (P = 0.123).

Comparative EffectivenessCohortLongitudinal Observational Studyn=193 medically treated OAG eyes (subdi…Ch5Ch12

This longitudinal observational study evaluated 282 subjects (60 healthy eyes, 193 medically treated open-angle glaucoma eyes, and 29 medically treated pseudoexfoliation glaucoma eyes) with a minimum 3-year follow-up, using serial spectral-domain OCT measurement of ganglion cell-inner plexiform layer thickness to determine thinning rates.

MethodologyCohortLongitudinal Observational Studyn=282 subjects (60 healthy eyes, 193 me…Ch5Ch28

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