Detection of Progressive Retinal Nerve Fiber Layer Thickness Loss With Optical Coherence Tomography Using 4 Criteria for Functional Progression

作者：Grewal Dilraj S; Sehi Mitra; Paauw James D; Greenfield David S^*

来源：Journal of Glaucoma, 2012, 21(4): 214-220.

DOI：10.1097/IJG.0b013e3182071cc7

• optical coherence tomography
• glaucoma progression
• standard automated perimetry
• retinal nerve fiber layer thickness

Purpose: To compare the rates of retinal nerve fiber layer (RNFL) thickness loss using optical coherence tomography (OCT) in progressing versus nonprogressing eyes using 4 methods to define functional progression. %26lt;br%26gt;Methods: Normal and glaucomatous eyes with %26gt;= 3 years of follow up were prospectively enrolled. Standard automated perimetry (Swedish Interactive Threshold Algorithm Standard 24-2) and OCT (Stratus OCT, Carl ZeissMeditec, Dublin, CA) imaging were performed every 6 months in glaucomatous eyes. OCT imaging was performed annually in normal eyes. Functional progression was determined using early manifest glaucoma trial criterion, visual field index (VFI), Progressor software, and the 3-omitting method. %26lt;br%26gt;Results: Seventy-six eyes (46 glaucoma and 30 normal) of 38 patients were enrolled with a mean follow-up of 43.9 +/- 5.02 months (range: 36 to 48mo). Eleven eyes progressed using Progressor criterion, 5 eyes using VFI, 2 eyes using the 3-omitting method, and 2 eyes using Early Manifest Glaucoma Trial criterion. The annual rate of average RNFL loss (mu m/y) was significantly greater (P %26lt; 0.05) in progressing versus nonprogressing eyes using Progressor (-1.0 +/- 1.3 vs. 0.02 +/- 1.6), VFI (-2.1 +/- 1.1 vs. -0.002 +/- 1.4), and the 3-omitting method (-2.2 +/- 0.2 vs. -0.1 +/- 1.5). Mean rate (mu m/y) of average and superior RNFL thickness change was similar (P %26gt; 0.05) in nonprogressing glaucomatous eyes compared with normal eyes. Using linear mixed-effect models, mean (P %26lt; 0.001) and peak (P = 0.01) intraocular pressure were significantly associated with rate of average RNFL atrophy in glaucomatous eyes. %26lt;br%26gt;Conclusions: Despite differences in criteria used to judge functional progression, eyes with standard automated perimetry progression have significantly greater rates of RNFL loss measured using OCT compared with nonprogressing eyes.

• 出版日期2012-5