TY - JOUR
T1 - Earlier Detection of Glaucoma Progression Using High-Density 3-Dimensional Spectral-Domain OCT Optic Nerve Volume Scans
AU - Ratanawongphaibul, Kitiya
AU - Tsikata, Edem
AU - Zemplenyi, Michele
AU - Lee, Hang
AU - Margeta, Milica A.
AU - Ondeck, Courtney L.
AU - Kim, Janice
AU - Pan, Billy X.
AU - Petrakos, Paul
AU - Coleman, Anne L.
AU - Yu, Fei
AU - de Boer, Johannes F.
AU - Chen, Teresa C.
N1 - Funding Information: Supported by the National Institutes of Health, Bethesda, Maryland (grant no.: UL1 RR 025758 [Harvard Catalyst Grant to T.C.C.]); Massachusetts Lions Eye Research Fund, New Bedford and Boston, Massachusetts (T.C.C.); American Glaucoma Society, San Francisco, California (Mid-Career Award [T.C.C.]); Fidelity Charitable Fund of Harvard University, Boston, Massachusetts (T.C.C.); the Department of Defense (Small Business Innovation Research award no.: DHP15-016 [T.C.C.]). The funding sources had no role in the study design or conduct of this research. J.F.dB.: Consultant ? UK-based law firm (expert testimony); Financial support ? TNO, Heidelberg Engineering, Dutch Science Foundation (NWO); Patent and Royalties ? Mass General Hospital, VU University. Obtained funding: Chen Publisher Copyright: © 2021 American Academy of Ophthalmology
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Purpose: To compare onset times of glaucoma progression among different glaucoma tests: disc photography (DP), visual field (VF) testing, 2-dimensional (2D) retinal nerve fiber layer (RNFL) thickness, and 3-dimensional (3D) spectral-domain (SD) OCT neuroretinal rim measurements. Design: Prospective, longitudinal cohort study. Participants: One hundred twenty-four eyes of 124 patients with open-angle glaucoma. Methods: Over a 5-year period, 124 patients with open-angle glaucoma underwent yearly DP, VF testing, SD OCT RNFL thickness scans, and optic nerve volume scans (Spectralis; Heidelberg Engineering), all performed on the same day. From high-density optic nerve volume scans, custom-built software calculated the minimum distance band (MDB) thickness, a 3D neuroretinal rim parameter. Patients were classified as glaucoma progressors or nonglaucoma progressors using event-based analysis. Progression by DP and VF testing occurred when 3 masked glaucoma specialists unanimously concurred. Progression by RNFL and MDB thickness occurred if change of more than test–retest variability was observed. Kaplan-Meier curves were constructed to analyze time-to-progression data. Kappa Coefficients were used to measure agreement of progressing eyes among methods. Main Outcome Measures: Time to glaucoma progression among all 4 methods. Results: Global MDB thickness detected glaucoma progression in the highest percentage of eyes (52.4%) compared with DP (16.1%; P < 0.001) and global RNFL thickness (15.3%; P < 0.001). Global MDB thickness detected glaucoma progression earlier than either DP (23 months vs. 44 months; P < 0.001) or global RNFL thickness (23 months vs. 33 months; P < 0.001). Among MDB progressing eyes, 46.2% were confirmed simultaneously or later by other conventional methods. Agreement of glaucoma-progressing eyes for all 4 methods in paired fashion were slight to fair (κ = 0.095–0.300). Conclusions: High-density 3D SD OCT neuroretinal rim measurements detected glaucoma progression approximately 1 to 2 years earlier compared with current clinically available structural tests (i.e., DP and 2D RNFL thickness measurements).
AB - Purpose: To compare onset times of glaucoma progression among different glaucoma tests: disc photography (DP), visual field (VF) testing, 2-dimensional (2D) retinal nerve fiber layer (RNFL) thickness, and 3-dimensional (3D) spectral-domain (SD) OCT neuroretinal rim measurements. Design: Prospective, longitudinal cohort study. Participants: One hundred twenty-four eyes of 124 patients with open-angle glaucoma. Methods: Over a 5-year period, 124 patients with open-angle glaucoma underwent yearly DP, VF testing, SD OCT RNFL thickness scans, and optic nerve volume scans (Spectralis; Heidelberg Engineering), all performed on the same day. From high-density optic nerve volume scans, custom-built software calculated the minimum distance band (MDB) thickness, a 3D neuroretinal rim parameter. Patients were classified as glaucoma progressors or nonglaucoma progressors using event-based analysis. Progression by DP and VF testing occurred when 3 masked glaucoma specialists unanimously concurred. Progression by RNFL and MDB thickness occurred if change of more than test–retest variability was observed. Kaplan-Meier curves were constructed to analyze time-to-progression data. Kappa Coefficients were used to measure agreement of progressing eyes among methods. Main Outcome Measures: Time to glaucoma progression among all 4 methods. Results: Global MDB thickness detected glaucoma progression in the highest percentage of eyes (52.4%) compared with DP (16.1%; P < 0.001) and global RNFL thickness (15.3%; P < 0.001). Global MDB thickness detected glaucoma progression earlier than either DP (23 months vs. 44 months; P < 0.001) or global RNFL thickness (23 months vs. 33 months; P < 0.001). Among MDB progressing eyes, 46.2% were confirmed simultaneously or later by other conventional methods. Agreement of glaucoma-progressing eyes for all 4 methods in paired fashion were slight to fair (κ = 0.095–0.300). Conclusions: High-density 3D SD OCT neuroretinal rim measurements detected glaucoma progression approximately 1 to 2 years earlier compared with current clinically available structural tests (i.e., DP and 2D RNFL thickness measurements).
KW - Glaucoma progression
KW - Neuroretinal rim
KW - Optic nerve
KW - Spectral-domain OCT
KW - Volume scans
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U2 - https://doi.org/10.1016/j.ogla.2021.03.010
DO - https://doi.org/10.1016/j.ogla.2021.03.010
M3 - Article
C2 - 33774215
SN - 2589-4234
VL - 4
SP - 604
EP - 616
JO - Ophthalmology Glaucoma
JF - Ophthalmology Glaucoma
IS - 6
ER -