Earlier Detection of Glaucoma Progression Using High-Density 3D Spectral-Domain Optical Coherence Tomography Optic Nerve Volume Scans

Citation:

Ratanawongphaibul K, Tsikata E, Zemplenyi M, Lee H, Margeta MA, Ondeck CL, Kim J, Pan BX, Petrakos P, Coleman AL, Yu F, de Boer JF, Chen TC. Earlier Detection of Glaucoma Progression Using High-Density 3D Spectral-Domain Optical Coherence Tomography Optic Nerve Volume Scans. Ophthalmol Glaucoma 2021;

Date Published:

2021 Mar 24

Abstract:

PURPOSE: To compare onset times of glaucoma progression among different glaucoma tests: disc photography (DP), visual field (VF) testing, two-dimensional (2D) retinal nerve fiber layer (RNFL) thickness, and three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) neuroretinal rim measurements. DESIGN: Prospective longitudinal cohort study PARTICIPANTS: One hundred and twenty-four eyes of 124 open angle glaucoma patients METHODS: Over a 5-year period, 124 open angle glaucoma patients had yearly DP, VFs, SD-OCT RNFL thickness scans, and optic nerve volume scans (Spectralis, Heidelberg Engineering, Heidelberg, Germany), 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 non-glaucoma progressors using event-based analysis. Progression by DP and VF occurred when 3 masked glaucoma specialists unanimously concurred. Progression by RNFL and MDB thickness occurred if there was change greater than test-retest variability. Kaplan-Meier curves were constructed to analyze time-to-progression data. Kappa coefficients were used to measure agreement of progressing eyes among modalities. MAIN OUTCOME MEASURES: Time to glaucoma progression among all 4 modalities RESULTS: Global MDB thickness detected glaucoma progression in the highest percentage of eyes (52.4%) compared to DP (16.1%, P<0.001), and global RNFL thickness (15.3%, P<0.001) respectively. Global MDB thickness detected glaucoma progression earlier than either DP (23 versus 44 months; P<0.001) or global RNFL thickness (23 versus 33 months; P<0.001). Among MDB progressing eyes, 46.2% were simultaneously or later confirmed by other conventional modalities. Agreement of glaucoma progressing eyes for all 4 modalities in paired fashion were slight to fair (k=0.095-0.300). CONCLUSION: High-density 3D SD-OCT neuroretinal rim measurements detected glaucoma progression approximately 1-2 years earlier compared to current clinically available structural tests (i.e. disc photos and 2D RNFL thickness measurements).

Last updated on 03/31/2021