Comparison of Rates of Progression of Macular OCT Measures in Glaucoma.
Rabiolo Alessandro, Mohammadzadeh Vahid, Fatehi Nima, Morales Esteban, Coleman Anne L, Law Simon K, Caprioli Joseph, Nouri-Mahdavi Kouros
AI Summary
This study compared macular OCT measures for glaucoma progression, finding ganglion cell complex (GCC) measurements best detect structural worsening across all glaucoma severities, making them optimal for monitoring deterioration.
Abstract
Purpose
The purpose of this study was to compare rates of change of various macular thickness measures and evaluate the influence of baseline damage on macular rates of change.
Methods
One hundred twelve eyes (112 patients) with ≥ 2 years of follow-up and ≥ 5 macular optical coherence tomography (OCT) images and 10-2 visual field (VF) tests were included. OCT measures of interests were full macular thickness (FMT), ganglion cell complex (GCC), ganglion cell/inner plexiform layer (GCIPL), ganglion cell layer (GCL), and outer retinal layer (ORL) thickness in 3° × 3° superpixels. Rates of change were estimated with linear regression and normalized by dividing rates by the average normative superpixel thickness. We compared rates of change and proportion of significantly worsening superpixels (detection rate) and improving superpixels (false discovery rate [FDR]) among macular measures as a function of baseline thickness and 10-2 VF status.
Results
Median (interquartile range [IQR]) baseline VF mean deviation, follow-up time, and number of VFs/OCTs were -7.6 dB (-11.8 to -3.8 dB), 4.5 years (4.0-5.0 years), and 9 (8-10), respectively. Normalized FMT and GCC rates of change were faster and detection rates were higher than GCIPL and GCL ( P < 0.001), but FMT had lower FDR than GCC ( P = 0.02); faster FMT rates were partially explained by ORL rates of change. GCC detection rates were less likely than GCIPL and GCL rates to decrease with diminishing baseline thickness or worse VF damage. In eyes with 10-2 VF worsening, GCC and GCL demonstrated the fastest rates of change.
Conclusions
GCC measurements are most likely to detect structural worsening along the spectrum of glaucoma severity. Although FMT rates of change are least influenced by baseline thickness, they partially reflect likely age-related ORL changes.
Translational relevance: GCC thickness measurements seem to be the optimal macular outcome measure for detection of glaucoma deterioration.
MeSH Terms
Shields Classification
Key Concepts6
Normalized full macular thickness (FMT) and ganglion cell complex (GCC) rates of change were faster and detection rates were higher than ganglion cell/inner plexiform layer (GCIPL) and ganglion cell layer (GCL) (P < 0.001) in 112 eyes with glaucoma.
Full macular thickness (FMT) had a lower false discovery rate (FDR) than ganglion cell complex (GCC) (P = 0.02) in 112 eyes with glaucoma.
Faster full macular thickness (FMT) rates of change were partially explained by outer retinal layer (ORL) rates of change in 112 eyes with glaucoma.
Ganglion cell complex (GCC) detection rates were less likely than ganglion cell/inner plexiform layer (GCIPL) and ganglion cell layer (GCL) rates to decrease with diminishing baseline thickness or worse 10-2 visual field (VF) damage in 112 eyes with glaucoma.
In eyes with 10-2 visual field (VF) worsening, ganglion cell complex (GCC) and ganglion cell layer (GCL) demonstrated the fastest rates of change among macular optical coherence tomography (OCT) measures in 112 eyes with glaucoma.
Ganglion cell complex (GCC) measurements are most likely to detect structural worsening along the spectrum of glaucoma severity, making them an optimal macular outcome measure for detection of glaucoma deterioration.
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