Comparison of Event-based Analysis Versus Trend-based Analysis in the Detection of Glaucoma Progression by Optical Coherence Tomography 3-Dimensional Rim Measurements.
Scott Tamara D, Guzman Aparicio Maria A, Ratanawongphaibul Kitiya, Lee Hang, Zemplenyi Michele, Tsikata Edem, Margeta Milica A, Ondeck Courtney L, Coleman Anne L, Yu Fei
AI Summary
This study found event-based analysis of OCT rim and RNFL thickness detects glaucoma progression in more patients and earlier than trend-based analysis, improving timely clinical intervention.
Abstract
Précis: Compared with trend-based analysis, event-based analysis detects OCT structural progression in more patients and at an earlier time point. Using event-based analysis, MDB rim thickness detects progression more often than RNFL thickness.
Purpose
To determine whether event-based or trend-based analysis best detects glaucoma progression using spectral domain optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and minimum distance band (MDB) neuroretinal rim measurements.
Methods
Over 5 years, 124 open angle glaucoma patients had yearly dilated eye examinations, disc photography, Humphrey visual field (HVF 24-2) testing, 2-dimensional (2D) OCT RNFL thickness measurements, and 3-dimensional (3D) OCT MDB rim measurements, all on the same day. One eye of each patient was analyzed, which was randomly selected if both eyes from a patient were eligible. Using global RNFL thickness and global MDB rim thickness, event-based progression was defined as change greater than normal aging change and expected inter-test variability. Trend-based analysis used linear regression with progression defined as rate of decline greater than age-related decline.
Results
The average follow-up for the 124 open angle glaucoma patients was 66.9±16.4 months. Event-based analysis was better than trend-based analysis because it detected progression in more patients (15.3% by RNFL event-based analysis versus 8.1% by RNFL trend-based analysis, P =0.025; 52.4% by MDB event-based analysis versus 9.7% by MDB trend-based analysis, P <0.001) and earlier (RNFL: mean 28.8 vs. 63.2 mo; P <0.001; MDB: mean 30.7 vs. 56.2 mo; P <0.003) whether using MDB rim thickness or RNFL thickness. Using event-based analysis, MDB rim thickness detected progression more often than RNFL thickness (52.4% vs. 15.3%; P <0.001).
Conclusions
Compared with trend-based analysis, event-based analysis detected OCT structural progression in more glaucoma patients and at an earlier time point.
MeSH Terms
Shields Classification
Key Concepts3
Event-based analysis detected progression in more open angle glaucoma patients (15.3% by RNFL event-based analysis versus 8.1% by RNFL trend-based analysis, P =0.025) and earlier (mean 28.8 vs. 63.2 months; P <0.001) compared to trend-based analysis when using retinal nerve fiber layer (RNFL) thickness.
Event-based analysis detected progression in more open angle glaucoma patients (52.4% by MDB event-based analysis versus 9.7% by MDB trend-based analysis, P <0.001) and earlier (mean 30.7 vs. 56.2 months; P <0.003) compared to trend-based analysis when using minimum distance band (MDB) neuroretinal rim measurements.
Using event-based analysis, minimum distance band (MDB) rim thickness detected progression more often than retinal nerve fiber layer (RNFL) thickness (52.4% vs. 15.3%; P <0.001) in open angle glaucoma patients.
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