Abstract
BackgroundTo evaluate the use of optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and visual field (VF) measurements in detecting disease progression in patients with early glaucoma.MethodsOver a 3-year period, this study examined 60 eyes of 39 glaucoma patients whose total deviation in the superior or inferior hemifield was more than -6 dB. All eyes underwent at least four serial RNFL measurements performed by Cirrus OCT, with the first and last measurements separated by at least three years. On the same day as the RNFL imaging, VF testing was also performed by using the Swedish Interactive Threshold Algorithm Standard 30–2 program of the Humphrey Field Analyzer. Serial RNFL thicknesses and VF progression were assessed using the Guided Progression Analysis (GPA) software program. RNFL thickness progression and VF progression were evaluated by the event analysis.ResultsThe mean observation period was 57.6 ± 10.0 months, and during this time, a total of 366 OCT and 366 VF measurements were performed. Using only OCT, progression was found in 2 eyes, while progression was found in 1 eye when only using VF GPA. When combined measurement findings were used, the analysis found progression in 8 eyes.ConclusionsWhen mild VF defect is present, OCT RNFL thickness measurements can be helpful in discerning glaucoma progression.
Highlights
To evaluate the use of optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and visual field (VF) measurements in detecting disease progression in patients with early glaucoma
We have recently reported that the average of the progressive hemifield total deviation (TD) at baseline for the both RNFL and VF progression was −3.21 ± 1.38 dB, while individually it was −2.17 ± 1.14 dB for RNFL progression and −9.12 ± 3.75 dB for VF progression [9]
If progression was noted in the inferior RNFL thickness, we evaluated the TD of the superior hemifield
Summary
To evaluate the use of optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and visual field (VF) measurements in detecting disease progression in patients with early glaucoma. Glaucoma is a progressive optic neuropathy characterized by the loss of retinal ganglion cells and the retinal nerve fiber layer (RNFL), with an associated visual field loss [1,2]. As a way of improving our ability to detect the presence we speculated that determination of the RNFL thickness by OCT might be an important diagnostic tool, as these measurements should be able to help discern glaucoma progression when the VF defect is mild. The purpose of our current study was to examine the relationship between the RNFL thickness and VF measurements, and evaluate the ability of using these findings to determine progression in patients with early glaucoma
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