Dataset Information

Longitudinal changes in peripapillary atrophy in the ocular hypertension treatment study: a case-control assessment.

ABSTRACT:

Purpose

To explore the association between peripapillary atrophy (PPA) area and conversion from ocular hypertension (OHT) to glaucoma.

Design

Prospective, longitudinal cohort study of cases and controls.

Participants

We included 279 age-matched and follow-up time-matched eyes with OHT that converted to glaucoma and 279 eyes with OHT that did not convert to glaucoma.

Methods

Initial and last acceptable optic disc photos were analyzed. Disc, α-zone, and β-zone PPA were traced independently by 2 trained readers and their areas were measured with Photoshop. The α-zone and β-zone areas were expressed as a percentage of optic disc area.

Main outcome measures

α-Zone and β-zone PPA size over time.

Results

Intraclass correlation coefficients (ICCs) demonstrated that readers had good agreement on disc area (ICC = 0.97) and β-zone (ICC = 0.82), but not α-zone (ICC = 0.48). The ß-zone, as a percentage of disc area, increased in size (P < 0.001) in both eyes with incident primary open-angle glaucoma (mean, 10.6%; standard deviation, 22.6%) and matched controls (mean, 10.1%; standard deviation, 33.7) over follow-up (mean, 12.3 years). The increase in size did not differ between cases and controls (P = 0.82). Enlargement of the β-zone was not correlated with follow-up time (P = 0.39).

Conclusions

The results did not show a difference in size of the β-zone at baseline between eyes that proceed to develop glaucoma and those that do not. Moreover, the β-zone enlarges equally in case and control eyes during follow-up.

SUBMITTER: Savatovsky E

PROVIDER: S-EPMC4682350 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

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Publications

Longitudinal changes in peripapillary atrophy in the ocular hypertension treatment study: a case-control assessment.

Savatovsky Eleonore E Mwanza Jean-Claude JC Budenz Donald L DL Feuer William J WJ Vandenbroucke Ruth R Schiffman Joyce C JC Anderson Douglas R DR

Ophthalmology 20140907 1

<h4>Purpose</h4>To explore the association between peripapillary atrophy (PPA) area and conversion from ocular hypertension (OHT) to glaucoma.<h4>Design</h4>Prospective, longitudinal cohort study of cases and controls.<h4>Participants</h4>We included 279 age-matched and follow-up time-matched eyes with OHT that converted to glaucoma and 279 eyes with OHT that did not convert to glaucoma.<h4>Methods</h4>Initial and last acceptable optic disc photos were analyzed. Disc, α-zone, and β-zone PPA were ...[more]

PMID: 25208858

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Project description:Background: This study aimed to assess the differences in the average and sectoral peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell plus inner plexiform layer (mGCIPL), and macular ganglion cell complex (mGCC) thickness using optical coherence tomography (OCT) in patients with pre-perimetric glaucoma (PPG) compared to those with early perimetric glaucoma (EG) and ocular hypertension (OHT). Methods: A comprehensive literature search of the PubMed database, the Cochrane Library, and Embase was performed from inception to March 2021. The weighted mean difference (WMD) with the 95% confidence interval (CI) was pooled for continuous outcomes. Results: Twenty-three cross-sectional studies comprising 2,574 eyes (1,101 PPG eyes, 1,233 EG eyes, and 240 OHT eyes) were included in the systematic review and meta-analysis. The pooled results demonstrated that the average pRNFL (WMD = 8.22, 95% CI = 6.32-10.12, P < 0.00001), mGCIPL (WMD = 4.83, 95% CI = 3.43-6.23, P < 0.00001), and mGCC (WMD = 7.19, 95% CI = 4.52-9.85, P < 0.00001) were significantly thinner in patients with EG than in those with PPG. The sectoral thickness of pRNFL, mGCIPL, and mGCC were also significantly lower in the EG eyes. In addition, the average pRNFL and mGCC were significantly thinner in the PPG eyes than those in the OHT eyes (pRNFL: WMD = -8.57, 95% CI = -9.88 to -7.27, P < 0.00001; mGCC: WMD = -3.23, 95% CI = -6.03 to -0.44, P = 0.02). Similarly, the sectoral pRNFL and mGCC were also significantly thinner in the PPG eyes than those in the OHT eyes. Conclusion: OCT-based measurements of peripapillary and macular structural alterations can be used to distinguish PPG from EG and OHT, which can help understand the pathophysiology of glaucoma at earlier stages. Studies that employ clock hour classification methods and longitudinal studies are needed to verify our findings. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=239798 CRD42021239798.

Project description:PurposeLongitudinal testing plays a key role in glaucoma management. Variability between visits hampers the ability to monitor progression. It has previously been shown that average intraocular pressure (IOP) exhibits seasonal fluctuations. This study examines whether visual field sensitivity also exhibits seasonal fluctuations and seeks to determine whether such fluctuations are correlated to seasonal IOP effects.DesignComparative case series.ParticipantsA total of 33 873 visits by 1636 participants enrolled in the Ocular Hypertension Treatment Study. Participants were split into 6 geographic zones according to the prevailing climate in their location.TestingAt each visit, standard automated perimetry was conducted on each eye, and IOP was measured.Main outcome measuresMixed effects regression models were formed to look for sinusoidal periodic effects on the change in perimetric mean deviation since the last visit (ΔMD) and on IOP, both overall and within each zone.ResultsWhen all the data were included, a significant seasonal effect on ΔMD was found with magnitude 0.06 dB, peaking in February (P < 0.001). Five of the 6 geographic zones exhibited significant seasonal effects on ΔMD, peaking between January and April, with magnitudes ranging from 0.04 dB (P = 0.049) to 0.21 dB (P < 0.001). Zones with greater climactic variation showed larger seasonal effects on ΔMD. All 6 zones exhibited a seasonal effect on IOP, peaking in January or February, with magnitudes ranging from 0.14 to 0.39 mmHg (P ≤ 0.02 in all cases). However, there was no evidence of a significant association between the magnitudes or dates of peaks of the 2 seasonal effects.ConclusionsThe mean deviation was significantly higher in winter than in summer. There is no evidence of an association with seasonal IOP fluctuations. The cause of the seasonal effect on visual field sensitivity is unknown. These findings may help shed light on the glaucomatous disease process and aid efforts to reduce test-retest variability.

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Project description:PurposePrimary open-angle glaucoma (POAG) is a major cause of blindness and visual disability. Several genetic risk factors for POAG and optic nerve features have been identified. We measured the relative risk for glaucoma that these factors contribute to participants in the Ocular Hypertension Treatment Study (OHTS).DesignComparative series.ParticipantsOne thousand fifty-seven of 1636 participants (65%) of the OHTS were enrolled in this genetics ancillary study.MethodsSamples of DNA were available from 1057 OHTS participants. Of these, 209 developed POAG (cases) and 848 did not develop glaucoma (controls) between 1994 and 2009. The frequencies of 13 risk alleles previously associated with POAG or with optic disc features in other cohorts were compared between POAG cases and controls in the OHTS cohort using analyses of variance. The 2 largest subgroups, non-Hispanic whites (n = 752; 70.7%) and blacks (n = 249, 23.7%), also were analyzed separately. The probability of glaucoma developing over the course of the OHTS was compared between participants stratified for transmembrane and coiled-coil domains 1 (TMCO1) risk alleles using Kaplan-Meier and Cox proportional hazards analyses.Main outcome measuresAssociation of POAG with known genetic factors.ResultsNo association was detected between the known POAG risk alleles when the OHTS cohort was examined as a whole. However, in the subgroup of non-Hispanic whites, allele frequencies at the TMCO1 locus were statistically different between cases and controls (P = 0.00028). By 13 years, non-Hispanic white participants with TMCO1 risk alleles had a 12% higher cumulative frequency of glaucoma developing than participants with no TMCO1 risk alleles. Moreover, the Cox proportional hazard analysis demonstrated that TMCO1 alleles increased relative risk comparable with that of some previously analyzed clinical measures (i.e., intraocular pressure).ConclusionsThe size of the OHTS cohort and its composition of 2 large racial subgroups may limit its power to detect some glaucoma risk factors. However, TMCO1 genotype was found to increase the risk of glaucoma developing among non-Hispanic whites, the largest racial subgroup in the OHTS cohort, at a magnitude similar to clinical predictors of disease that long have been associated with glaucoma.

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Dataset Information

Longitudinal changes in peripapillary atrophy in the ocular hypertension treatment study: a case-control assessment.

Purpose

Design

Participants

Methods

Main outcome measures

Results

Conclusions

Publications

Longitudinal changes in peripapillary atrophy in the ocular hypertension treatment study: a case-control assessment.

Similar Datasets

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