Novel Vertical Cup-to-Disc Classification to Identify Normal Eyes That Maintain Non-Glaucoma Status: A 10-Year Longitudinal Study.
Ikeda Yoko, Mori Kazuhiko, Maruyama Yuko, Ueno Morio, Yoshii Kengo, Yamamoto Yuji, Imai Kojiro, Omi Natsue, Sato Ryuichi, Sato Fumiko
AI Summary
A new VCDR classification identified normal eyes, particularly N1/N2, with very low 10-year glaucoma transition rates, providing a robust control for future genomic studies.
Abstract
Prcis: We propose a new classification model to serve as a control for future genomic studies of glaucoma by distinguishing normal subjects maintaining non-glaucoma status for 10 years using the vertical cup-to-disc ratio (VCDR).
Purpose
This study aimed to develop a classification for distinguishing subjects maintaining non-glaucoma status for 10 years using the VCDR.
Participants and methods: Among 842 volunteers 40 years and older, 421 volunteers participated in the second ophthalmic examination 10 years after their first examination. Each volunteer was diagnosed either as healthy normal or glaucoma suspect (GS) in the first glaucoma screening examinations. The former was further classified into the 3 grades of N1, N2, and N3. Specifically, N1 represented (1) VCDR <0.3; (2) no notching or nerve fiber layer defect; and (3) no undermining, N2 indicated 0.3≤VCDR<0.6 and conditions (2) and (3) of N1; and N3 represented 0.3≤VCDR<0.6 with undermining and condition (2), or 0.6≤VCDR<0.7 and condition (2) of N1. Glaucoma transition rates (GTRs) were evaluated in 421 volunteers who returned to participate after a 10-year period.
Results
GTRs were calculated as 1.3% in both N1 and N2, 3.9% in N3, and 18.2% in GS. The ratio of volunteers in the same category maintenance rate increased from N1 to N3.
Conclusion
GTRs were lower in N1 and N2 than in N3 or GS during the 10-year study period. This novel classification of healthy non-glaucoma subjects may help identify those, especially Japanese males, who maintain a non-glaucoma status for an extended period of 10 years.
MeSH Terms
Shields Classification
Key Concepts5
Glaucoma transition rates (GTRs) over a 10-year period were 1.3% in N1, 1.3% in N2, 3.9% in N3, and 18.2% in glaucoma suspect (GS) subjects.
Glaucoma transition rates (GTRs) were lower in N1 and N2 classification groups compared to N3 or glaucoma suspect (GS) groups during the 10-year study period.
A novel classification model, based on vertical cup-to-disc ratio (VCDR), was developed to identify normal subjects who maintain non-glaucoma status for 10 years, serving as a control for future genomic studies of glaucoma.
Among 842 volunteers aged 40 years and older, 421 volunteers participated in a second ophthalmic examination 10 years after their first examination, with initial diagnoses of healthy normal or glaucoma suspect (GS).
The healthy normal subjects were further classified into N1 (VCDR <0.3, no notching or nerve fiber layer defect, no undermining), N2 (0.3≤VCDR<0.6, no notching or nerve fiber layer defect, no undermining), and N3 (0.3≤VCDR<0.6 with undermining and no notching or nerve fiber layer defect, or 0.6≤VCDR<0.7 and no notching or nerve fiber layer defect).
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