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Am J OphthalmolFebruary 20220 citations

Impact of Glaucoma Severity on Rates of Neuroretinal Rim, Retinal Nerve Fiber Layer, and Macular Ganglion Cell Layer Thickness Change.

Kim Yong Woo, Sharpe Glen P, Hutchison Donna M, Rafuse Paul E, Shuba Lesya M, Nicolela Marcelo T, Vianna Jayme R, Chauhan Balwantray C


AI Summary

This study found glaucoma severity didn't influence OCT thickness change rates, but macular GCL thickness best distinguished glaucoma progression from healthy aging, suggesting its utility in monitoring.

Abstract

Purpose

To determine the impact of glaucoma severity on rates of change of minimum rim width (MRW), peripapillary retinal nerve fiber layer (RNFL), and macular ganglion cell layer (GCL) thickness.

Design

Prospective, cohort study.

Methods

Glaucoma patients and healthy subjects had optical coherence tomography scans at 6-month intervals. Individual rates of change for MRW, RNFL, and GCL thickness were estimated with ordinary least-squares regression. Linear mixed-effect models were used to estimate the rate of change of each parameter and evaluate the impact of glaucoma severity (expressed by visual field mean deviation, MD) and age on these rates.

Results

A total of 132 glaucoma patients and 57 healthy subjects were followed for a median of 4.3 years and 3.7 years, respectively. Healthy subjects had a statistically significant deterioration in MRW (-1.66 µm/year), RNFL (-0.46 µm/year), and GCL thickness (-0.22 µm/year). While glaucoma patients had a faster rate of change in each parameter compared with healthy subjects, only GCL thickness showed a statistically significant group difference (mean difference: -0.17 µm/year; P = .03). Older baseline age was associated with faster GCL thickness change (-0.07 µm/year; P = .03), but not other parameters. Baseline MD had no impact on the subsequent rates of change in any of the parameters.

Conclusions

The rates of MRW, RNFL, and GCL thickness change were not significantly influenced by glaucoma severity at baseline; however, GCL thickness was able to statistically contrast the rate of change between healthy subjects and glaucoma patients throughout the disease spectrum.


MeSH Terms

Cohort StudiesGlaucomaHumansIntraocular PressureNerve FibersProspective StudiesRetinal Ganglion CellsTomography, Optical Coherence

Key Concepts6

Glaucoma patients (n=132) had a faster rate of change in minimum rim width (MRW), peripapillary retinal nerve fiber layer (RNFL), and macular ganglion cell layer (GCL) thickness compared with healthy subjects, but only GCL thickness showed a statistically significant group difference (mean difference: -0.17 µm/year; P = .03) over a median follow-up of 4.3 years.

Comparative EffectivenessCohortProspective Cohortn=132 glaucoma patients and 57 healthy …Ch5Ch12

Older baseline age was associated with a faster macular ganglion cell layer (GCL) thickness change (-0.07 µm/year; P = .03) in glaucoma patients and healthy subjects, but it was not associated with changes in minimum rim width (MRW) or peripapillary retinal nerve fiber layer (RNFL) thickness.

PrognosisCohortProspective Cohortn=132 glaucoma patients and 57 healthy …Ch5Ch10

Baseline visual field mean deviation (MD), an indicator of glaucoma severity, had no impact on the subsequent rates of change in minimum rim width (MRW), peripapillary retinal nerve fiber layer (RNFL), or macular ganglion cell layer (GCL) thickness in glaucoma patients (n=132).

PrognosisCohortProspective Cohortn=132 glaucoma patientsCh5Ch6

The rates of minimum rim width (MRW), peripapillary retinal nerve fiber layer (RNFL), and macular ganglion cell layer (GCL) thickness change were not significantly influenced by glaucoma severity at baseline.

PrognosisCohortProspective Cohortn=132 glaucoma patientsCh5Ch12

Macular ganglion cell layer (GCL) thickness was able to statistically contrast the rate of change between healthy subjects and glaucoma patients throughout the disease spectrum, despite glaucoma severity at baseline not significantly influencing the rates of change in MRW, RNFL, and GCL thickness.

DiagnosisCohortProspective Cohortn=132 glaucoma patients and 57 healthy …Ch5Ch12

Healthy subjects (n=57) experienced a statistically significant deterioration in minimum rim width (MRW) at a rate of -1.66 µm/year, peripapillary retinal nerve fiber layer (RNFL) at -0.46 µm/year, and macular ganglion cell layer (GCL) thickness at -0.22 µm/year over a median follow-up of 3.7 years.

PrognosisCohortProspective Cohortn=57 healthy subjectsCh5Ch10

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