Vulnerability Zone of Glaucoma Progression in Combined Wide-field Optical Coherence Tomography Event-based Progression Analysis.
Lee Won June, Park Ki Ho, Seong Mincheol
AI Summary
This study found glaucoma progression frequently occurs in the macular vulnerability zone, often extending towards the fovea. This combined OCT analysis improves understanding of spatial progression patterns.
Abstract
Purpose
To investigate the spatial characteristics and patterns of structural progression using the combined retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer event-based progression analysis feature provided by the Guided Progression Analysis (GPA) software of spectral-domain optical coherence tomography.
Methods
In this retrospective observational study, we evaluated 89 patients with open-angle glaucoma showing clinically confirmed structural progression within a minimum follow-up period of 3 years. For each eye, the RNFL and ganglion cell-inner plexiform layer GPA data were extracted from serial spectral-domain optical coherence tomography (HD-OCT 4000, Carl Zeiss Meditec, Inc., Dublin, CA) data from 2012 to 2017 (available in commercial report). A combined wide-field GPA map was merged using vascular landmark-guided superimposition of RNFL and ganglion cell-inner plexiform layer GPA event-based progression maps onto the RNFL image (resulting in the GPA PanoMaps: proposed in this study). The pattern of progressive structural changes was evaluated by comparing the baseline combined wide-field OCT deviation maps (PanoMap deviation maps: available in commercial report) and GPA PanoMaps at the time the first progression was detected and the GPA PanoMaps at the last follow-up. Spatial characteristics and patterns of glaucoma structural progression on GPA PanoMaps were evaluated.
Results
Progressive structural progression was detected most frequently at the macular vulnerability zone (MVZ), with the peripapillary and macular progression being well-correlated spatially. Compared with the baseline structural change on PanoMap, the progressive structural changes extended toward the fovea at both the peripapillary and macular areas. A spatial difference was observed between the areas where structural damage was frequently found on PanoMap (peripapillary inferoinferior sector and macular MVZ) and areas where progression was frequently found on GPA PanoMap (peripapillary and macular MVZ).
Conclusions
The patterns of progressive glaucomatous structural changes in both the peripapillary and macular areas were confirmed on the combined wide-field GPA map (GPA PanoMap). An analysis of the progression pattern using the GPA PanoMap facilitates the understanding of the spatial relation between the peripapillary and macular areas in glaucoma.
MeSH Terms
Shields Classification
Key Concepts4
Progressive structural progression in open-angle glaucoma was detected most frequently at the macular vulnerability zone (MVZ) using combined wide-field optical coherence tomography (OCT) event-based progression analysis (GPA PanoMap).
In open-angle glaucoma patients, the peripapillary and macular progression were well-correlated spatially using combined wide-field optical coherence tomography (OCT) event-based progression analysis (GPA PanoMap).
Compared with baseline structural changes on PanoMap, progressive structural changes in open-angle glaucoma extended toward the fovea at both the peripapillary and macular areas using combined wide-field optical coherence tomography (OCT) event-based progression analysis (GPA PanoMap).
A spatial difference was observed between areas of frequent structural damage on PanoMap (peripapillary inferoinferior sector and macular MVZ) and areas of frequent progression on GPA PanoMap (peripapillary and macular MVZ) in patients with open-angle glaucoma.
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