Dataset Information

The structure and function relationship in glaucoma: implications for detection of progression and measurement of rates of change.

ABSTRACT:

Purpose

To evaluate the relationship between change in estimated retinal ganglion cell (RGC) counts and change in measures of functional and structural damage in glaucoma, from cross-sectional data.

Methods

The study included 397 eyes of 397 patients with glaucoma, suspects, and healthy individuals. All eyes underwent testing with standard automated perimetry (SAP) and spectral-domain optical coherence tomography (SD-OCT). Estimates of retinal ganglion cell (RGC) counts were obtained from SAP and SD-OCT using a previously derived algorithm. Smoothing spline curves were fitted to investigate the relationship between functional/structural parameters and RGC counts. The first derivatives (i.e., slopes) of these curves were obtained to investigate the relationship between changes in these measures.

Results

A nonlinear relationship was observed between SAP mean deviation (MD) and RGC counts. The same amount of RGC loss corresponded to largely different amounts of MD change depending on the stage of the disease. For SDOCT average retinal nerve fiber layer (RNFL) thickness, a linear relationship was seen with RGC counts throughout most of the spectrum of disease, but reaching a plateau in advanced glaucoma. Changes in RGC counts for eyes with early damage corresponded to small changes in MD, but to relatively larger changes in RNFL thickness. For eyes with advanced disease, changes in RGC counts produced relatively larger changes in MD but only small or no changes in average RNFL thickness.

Conclusions

The analysis and interpretation of rates of SAP and SD-OCT change, as indicators of the velocity of neural damage in glaucoma, should take into account the severity of the disease.

SUBMITTER: Medeiros FA

PROVIDER: S-EPMC3466074 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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Publications

The structure and function relationship in glaucoma: implications for detection of progression and measurement of rates of change.

Medeiros Felipe A FA Zangwill Linda M LM Bowd Christopher C Mansouri Kaweh K Weinreb Robert N RN

Investigative ophthalmology & visual science 20121005 11

<h4>Purpose</h4>To evaluate the relationship between change in estimated retinal ganglion cell (RGC) counts and change in measures of functional and structural damage in glaucoma, from cross-sectional data.<h4>Methods</h4>The study included 397 eyes of 397 patients with glaucoma, suspects, and healthy individuals. All eyes underwent testing with standard automated perimetry (SAP) and spectral-domain optical coherence tomography (SD-OCT). Estimates of retinal ganglion cell (RGC) counts were obtai ...[more]

PMID: 22893677

Similar Datasets

Project description:PurposeTo investigate the relationship between longitudinal changes in macular thickness measurements from OCT and changes in central visual field (VF) in patients with glaucoma with central or advanced damage at baseline.DesignLongitudinal cohort study.ParticipantsA total of 116 eyes with ≥3 years of follow-up and ≥5 macular OCT images and central 10° VF tests were selected.MethodsOCT superpixels and VF locations were matched correcting for retinal ganglion cell (RGC) displacement. Superpixel thickness and VF total deviation (TD) values, in both logarithmic and linear scales, were averaged within 3 eccentricities (3.4°, 5.6°, and 6.8°) and superior and inferior hemiretinas and hemifields. We estimated pointwise TD rates of change and rates of change at superpixels for full macular thickness (FMT), ganglion cell complex (GCC), ganglion cell inner plexiform layer (GCIPL), and ganglion cell layer (GCL). Correlation of structure-function (SF) rates of change was investigated with parametric tests. We compared the proportion of worsening and positive slopes for superpixels and VF test locations (negative vs. positive rates of change with P < 0.05) throughout the follow-up period. Permutation analyses were used to control specificity.Main outcome measuresMagnitude of correlation between structural and functional rates of change and proportion of worsening and positive slopes as a function of follow-up time.ResultsThe median (interquartile range) follow-up and number of exams were 4.2 (3.7-4.6) years and 8 (7-9), respectively. The highest correlation of change rates was observed at 3.4° and 5.6° eccentricities (r = 0.24, 0.41, 0.40, and 0.40 for FMT, GCC, GCIPL, and GCL for 3.4° eccentricity and r = 0.28, 0.32, 0.31, and 0.32 for FMT, GCC, GCIPL, and GCL for 5.6° eccentricity, respectively). Although GCC measures demonstrated the highest overall longitudinal SF correlations, the differences were not statistically significant. Significant structural worsening was more frequently detected than functional deterioration at 3- and 5-year time points (P < 0.025). Permutation analyses also confirmed this finding.ConclusionsCorrelations between central structural and functional rates of change were weak to fair in this cohort. Structural changes were detected more frequently than functional changes. Measurements of both structure and function are required for optimal detection of central progression.

Dataset Information

The structure and function relationship in glaucoma: implications for detection of progression and measurement of rates of change.

Purpose

Methods

Results

Conclusions

Publications

The structure and function relationship in glaucoma: implications for detection of progression and measurement of rates of change.

Similar Datasets

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