Factors Associated With Visual Field Progression in Cirrus Optical Coherence Tomography-guided Progression Analysis: A Topographic Approach.

Abstract

To identify factors associated with visual field (VF) progression in optical coherence tomography (OCT)-guided progression analysis (GPA) using a topographic approach. Topographic components of OCT-GPA maps (Cirrus HD-OCT; Carl Zeiss Meditec) were classified according to location (temporal, superotemporal, superonasal, nasal, inferornasal, and inferotemporal), size (small, medium, and large), shape (wedge and irregular types), and pattern of retinal nerve fiber layer (RNFL) progression (widening, deepening, and new development). All positive findings in OCT-GPA (RNFL thickness maps, profiles, and average RNFL thickness) were defined as strong RNFL progression. VF progression was determined by linear regression analysis of VF mean deviation over time. Univariate and multivariate logistic regression analyses were performed to evaluate the association of VF progression with OCT-GPA parameters. In total, 276 primary open-angle glaucoma patients were followed up for 5.1 years. According to OCT-GPA, 89 eyes were found to have RNFL progression. Of these, VF progression was detected in 27 (30.3%) eyes. Eyes with progressed VF group showed topographically different characteristics, which were wedge-shaped (80.6%), large-sized (40.0%), and widening (69.5%) or deepening (11.1%) pattern of RNFL progression in the inferotemporal (44.4%) and superotemporal (30.6%) regions, compared with eyes with non-progressed VF group. In multivariate analysis, strong RNFL progression and widening or deepening pattern of RNFL progression were significantly associated with VF progression (P=0.012 and 0.016, respectively). Topographic analysis in OCT-GPA maps showed different characteristics between progressed VF and nonprogressed VF groups. Glaucoma patients with widening or deepening pattern of RNFL progression should be carefully monitored for greater risk of VF progression.