Effects of Optic Nerve Head Structures on Retinal Nerve Fiber Layer Defects in Primary Open Angle Glaucoma Eyes: Analyses Using Retinal Optical Texture Analysis.
Miki Atsuya, Araie Makoto, Leung Christopher Kai Shun, Nishigaki Masashi, Murata Hiroshi, Kikawa Tsutomu, Sugiyama Kazuhisa, Higashide Tomomi, Saito Hitomi, Aihara Makoto
AI Summary
This study found that in glaucoma patients, the extent of retinal nerve fiber layer defects detected by ROTA was associated with optic nerve head gamma zone area, suggesting this structural change reflects axonal damage.
Abstract
Purpose
To elucidate associations between optic nerve head (ONH) structures and the retinal nerve fiber layer optical texture analysis (ROTA)-detected retinal nerve fiber layer defects (RNFLDs) in primary open angle glaucoma (POAG) eyes.
Design
Prospective cross-sectional observational study.
Participants
This study enrolled 136 eyes of 109 POAG patients.
Methods
All participants underwent comprehensive ophthalmologic examinations including standard automated perimetry and swept-source optical coherence tomography (SS-OCT). Two independent graders assessed ROTA images for the presence, location, and width of RNFLDs. Multivariable linear mixed effects model was used to investigate factors independently associated with ROTA-detected RNFLDs. Explanatory variables were systemic and ocular factors such as age, axial length (AXL), SS-OCT-derived ONH structural parameters such as Bruch membrane opening-centered circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and gamma zone area, and average visual field sensitivity (1/Lambert) (VFS average ).
Main outcome measures
Width and number of RNFLDs.
Results
RNFLD detection rates by ROTA were 86.8% overall, 69.0% and 94.7% in the early and moderate stages of POAG eyes, and 86.5% and 87.2% in the highly myopic (AXL >26.0 mm) and non-highly myopic eyes, respectively. Summed width of RNFLD per eye was positively correlated with gamma-zone area (P = .0007) and negatively correlated with age, cpRNFLT, and VFS average (P = .0111, .0001, .0124), whereas the number of RNFLDs per eye correlated negatively with age, cpRNFLT, and VFS average (P = .0153, .0029, .0007).
Conclusions
The ROTA-detected extent of axonal damage was associated with ONH structural change represented by gamma zone area in POAG eyes after adjustment for other possible confounding factors.
Key Concepts5
The retinal nerve fiber layer optical texture analysis (ROTA) detected retinal nerve fiber layer defects (RNFLDs) in 86.8% of primary open angle glaucoma (POAG) eyes overall, 69.0% in early-stage POAG eyes, and 94.7% in moderate-stage POAG eyes.
The retinal nerve fiber layer optical texture analysis (ROTA) detected retinal nerve fiber layer defects (RNFLDs) in 86.5% of highly myopic primary open angle glaucoma (POAG) eyes (axial length >26.0 mm) and 87.2% in non-highly myopic POAG eyes.
In primary open angle glaucoma (POAG) eyes, the summed width of retinal nerve fiber layer defects (RNFLDs) per eye was positively correlated with gamma-zone area (P = .0007) and negatively correlated with age (P = .0111), Bruch membrane opening-centered circumpapillary retinal nerve fiber layer thickness (cpRNFLT) (P = .0001), and average visual field sensitivity (VFS average) (P = .0124).
In primary open angle glaucoma (POAG) eyes, the number of retinal nerve fiber layer defects (RNFLDs) per eye correlated negatively with age (P = .0153), Bruch membrane opening-centered circumpapillary retinal nerve fiber layer thickness (cpRNFLT) (P = .0029), and average visual field sensitivity (VFS average) (P = .0007).
The retinal nerve fiber layer optical texture analysis (ROTA)-detected extent of axonal damage was associated with optic nerve head (ONH) structural change, specifically gamma zone area, in primary open angle glaucoma (POAG) eyes after adjustment for other possible confounding factors.
Related Articles5
Inner Retinal Reflectivity Loss and Concurrent Thickening Predict Short-Term Conversion to Neovascular AMD.
Case-Control StudyAge-related changes in optical coherence tomography glaucoma-related parameters: A systematic review.
Systematic ReviewAssociation of Optic Nerve Head Metrics and Parapapillary Gamma Zone With Myopia Onset and Progression in Children: The Hong Kong Children Eye Study.
Cohort StudyArtificial Intelligence for Optical Coherence Tomography in Glaucoma.
ReviewGaze-Induced Optic Nerve Head Deformations Are Greater in High Myopia and Strains Increase With Axial Length.
Observational StudyIs this article assigned to the wrong chapter(s)? Let us know.