Patterns of Retinal Nerve Fiber Layer Loss in Different Subtypes of Open Angle Glaucoma Using Spectral Domain Optical Coherence Tomography.
Baniasadi Neda, Paschalis Eleftherios I, Haghzadeh Mahdi, Ojha Pallavi, Elze Tobias, Mahd Mufeed, Chen Teresa C
AI Summary
This study found distinct retinal nerve fiber layer thinning patterns among open-angle glaucoma subtypes, with pigmentary glaucoma showing more superior loss and pseudoexfoliation glaucoma having greater inter-eye asymmetry, aiding differentiated diagnosis.
Abstract
Purpose of the study: The purpose of the study was to determine whether there are different patterns of retinal nerve fiber layer (RNFL) thinning as measured by spectral domain optical coherence tomography (SD-OCT) for 4 subtypes of open angle glaucoma (OAG): primary OAG (POAG), normal tension glaucoma (NTG), pseudoexfoliation glaucoma (PXG), and pigmentary glaucoma (PDG) and to compare them with normal controls.
Materials and methods
SD-OCT RNFL thickness values were measured for 4 quadrants and for 4 sectors (ie, superior-nasal, superior-temporal, inferior-nasal, and inferior-temporal). Differences in RNFL thickness values between groups were analyzed using analysis of variance. Paired t tests were used for quadrant comparisons.
Results
Two hundred eighty-five participants (102 POAG patients, 33 with NTG, 48 with PXG, 13 with PDG, and 89 normal patients) were included in this study. All 4 subtypes of OAG showed significant RNFL thinning in the superior, inferior, and nasal quadrants as well as the superior-temporal and inferior-temporal sectors (all P-values <0.0001) compared with normals. POAG and NTG patients had greater RNFL thinning inferiorly and inferior-temporally than superiorly (P-values: 0.002 to 0.018 and 0.006, respectively) compared with PXG patients. In contrast, PDG patients had greater RNFL thinning superiorly and superior-nasally than inferiorly compared with other OAG subtypes (ie, POAG, NTG, PXG groups, with P-values: 0.009, 0.003, 0.009, respectively). Of the 4 OAG subtypes, PXG patients exhibited the greatest degree of inter-eye RNFL asymmetry.
Conclusions
This study suggests that SD-OCT may be able to detect significant differences in patterns of RNFL thinning for different subtypes of OAG.
MeSH Terms
Shields Classification
Key Concepts5
All four subtypes of open angle glaucoma (primary OAG, normal tension glaucoma, pseudoexfoliation glaucoma, and pigmentary glaucoma) showed significant retinal nerve fiber layer (RNFL) thinning in the superior, inferior, and nasal quadrants, as well as the superior-temporal and inferior-temporal sectors (all P-values <0.0001) compared with normal controls.
Primary OAG and normal tension glaucoma patients had greater retinal nerve fiber layer (RNFL) thinning inferiorly and inferior-temporally than superiorly (P-values: 0.002 to 0.018 and 0.006, respectively) compared with pseudoexfoliation glaucoma patients.
Pigmentary glaucoma patients had greater retinal nerve fiber layer (RNFL) thinning superiorly and superior-nasally than inferiorly compared with other open angle glaucoma subtypes (primary OAG, normal tension glaucoma, pseudoexfoliation glaucoma groups, with P-values: 0.009, 0.003, 0.009, respectively).
Of the four open angle glaucoma subtypes (primary OAG, normal tension glaucoma, pseudoexfoliation glaucoma, and pigmentary glaucoma), pseudoexfoliation glaucoma patients exhibited the greatest degree of inter-eye retinal nerve fiber layer (RNFL) asymmetry.
The study included 285 participants, consisting of 102 primary open angle glaucoma patients, 33 normal tension glaucoma patients, 48 pseudoexfoliation glaucoma patients, 13 pigmentary glaucoma patients, and 89 normal patients.
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