Dataset Information

Retinal nerve fibre layer thickness floor and corresponding functional loss in glaucoma.

ABSTRACT: To estimate the floor of retinal nerve fibre layer (RNFL) thickness measurements and the corresponding retinal sensitivity loss in glaucoma.Visual field (VF), Spectralis RNFL (83 patients and 37 healthy subjects) and RTVue RNFL data obtained separately (56 patients and 36 healthy subjects) were reviewed. Global and quadrant residual layer thicknesses and corresponding VF losses were estimated using two Bayesian change point models.The respective residual thicknesses from change point model 1 (CPM1) on Spectralis and RTVue (respectively) were 49.9 and 70.6?µm globally, 57.1 and 83.7?µm superiorly, 55.2 and 79.0?µm inferiorly, 43.1 and 60.5?µm nasally, and 40.1 and 59.5?µm temporally. Corresponding VF losses ranged between -25.1 and -21.7?dB (Spectralis) and between -21.8 and -3.4?dB (RTVue). From CPM2, RNFL thinning reached horizontal asymptotes at VF losses between -18.0 and -10.7?dB (Spectralis) and between -12.1 and -2.5?dB (RTVue). There were no significant differences between postchange point residual layer thicknesses from CPM1 and CPM2 on Spectralis (37.0-50.8?µm vs 38.3-56.0?µm) and RTVue (60.6-80.5?µm vs 58.4-88.8?µm).Global RNFL thinning reaches the floor at a smaller VF loss level with Spectralis than with RTVue. The nasal and temporal quadrants retain thinner residual layers than superior and inferior quadrant RNFL. Measuring RNFL below their minimums will not yield useful clinical information.

SUBMITTER: Mwanza JC

PROVIDER: S-EPMC4441828 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Retinal nerve fibre layer thickness floor and corresponding functional loss in glaucoma.

Mwanza Jean-Claude JC Budenz Donald L DL Warren Joshua L JL Webel Aaron D AD Reynolds Courtney E CE Barbosa Diego T DT Lin Shan S

The British journal of ophthalmology 20141209 6

<h4>Aim</h4>To estimate the floor of retinal nerve fibre layer (RNFL) thickness measurements and the corresponding retinal sensitivity loss in glaucoma.<h4>Methods</h4>Visual field (VF), Spectralis RNFL (83 patients and 37 healthy subjects) and RTVue RNFL data obtained separately (56 patients and 36 healthy subjects) were reviewed. Global and quadrant residual layer thicknesses and corresponding VF losses were estimated using two Bayesian change point models.<h4>Results</h4>The respective residu ...[more]

PMID: 25492547

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Project description:BackgroundMultifocal pupillographic objective perimetry (mfPOP) is a novel method for assessing functional change in diseases like glaucoma. Previous research has suggested that, in contrast to the pretectally-mediated melanopsin response of intrinsically photosensitive retinal ganglion cells, mfPOP responses to transient onset stimuli involve the extrastriate cortex, and thus the main visual pathway. We therefore investigate the correlation between peripapillary retinal nerve fibre layer (pRNFL) thickness and glaucomatous visual field changes detected using mfPOP. Parallel analyses are undertaken using white on white standard automated perimetry (SAP) for comparison.MethodsTwenty-five glaucoma patients and 24 normal subjects were tested using SAP, 3 mfPOP variants, and optical coherence tomography (OCT). Arcuate clusters of the SAP and mfPOP deviations were weighted according to their contribution to published arcuate divisions of the retinal nerve fibre layer. Structure-function correlation coefficients (r) were computed between pRNFL clock-hour sector thickness measurements, and the local visual field sensitivities from both SAP and mfPOP.ResultsThe strongest correlation was observed in the superior-superotemporal disc sector in patients with worst eye SAP MD < -12 dB: r = 0.93 for the mfPOP LumBal test (p < 0.001). Correlations across all disc-sectors were strongest in these same patients in both SAP and mfPOP: SAP r = 0.54, mfPOP LumBal r = 0.55 (p < 0.001). In patients with SAP MD ≥ -6 dB in both eyes, SAP correlations across all sectors were higher than mfPOP; mfPOP correlations however, were higher than SAP in more advanced disease, and in normal subjects.ConclusionsFor both methods the largest correlations with pRNFL thickness corresponded to the inferior nasal field of more severely damaged eyes. Head-to-head comparison of mfPOP and SAP showed similar structure-function relationships. This agrees with our recent reports that mfPOP primarily stimulates the cortical drive to the pupils.

Project description:PurposeCircumpapillary retinal nerve fiber layer thickness (RNFLT) measurement aids in the clinical diagnosis of glaucoma. Spectral domain optical coherence tomography (SD-OCT) machines measure RNFLT and provide normative color-coded plots. In this retrospective study, we investigate whether normative percentiles of RNFLT (pRNFLT) from Spectralis SD-OCT improve prediction of glaucomatous visual field loss over raw RNFLT.MethodsA longitudinal database containing OCT scans and visual fields from Massachusetts Eye & Ear glaucoma clinic patients was generated. Reliable OCT-visual field pairs were selected. Spectralis OCT normative distributions were extracted from machine printouts. Supervised machine learning models compared predictive performance between pRNFLT and raw RNFLT inputs. Regional structure-function associations were assessed with univariate regression to predict mean deviation (MD). Multivariable classification predicted MD, pattern standard deviation, MD change per year, and glaucoma hemifield test.ResultsThere were 3016 OCT-visual field pairs that met the reliability criteria. Spectralis norms were found to be independent of age, sex, and ocular magnification. Regional analysis showed significant decrease in R2 from pRNFLT models compared to raw RNFLT models in inferotemporal sectors, across multiple regressors. In multivariable classification, there were no significant improvements in area under the curve of receiver operating characteristic curve (ROC-AUC) score with pRNFLT models compared to raw RNFLT models.ConclusionsOur results challenge the assumption that normative percentiles from OCT machines improve prediction of glaucomatous visual field loss. Raw RNFLT alone shows strong prediction, with no models presenting improvement by the manufacturer norms. This may result from insufficient patient stratification in tested norms.Translational relevanceUnderstanding correlation of normative databases to visual function may improve clinical interpretation of OCT data.

Dataset Information

Retinal nerve fibre layer thickness floor and corresponding functional loss in glaucoma.

Publications

Retinal nerve fibre layer thickness floor and corresponding functional loss in glaucoma.

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