Comparison of Longitudinal Changes in Functional and Structural Measures for Evaluating Progression of Glaucomatous Optic Neuropathy

摘要

Purpose: We compared longitudinal changes in functional and structural measures in eyes with glaucomatous optic neuropathy. Methods: Circumpapillary retinal nerve fiber layer thickness (cpRNFL) and macular ganglion cell complex thickness (mGCC) were measured using spectral-domain optical coherence tomography (SD-OCT; RTVue). The Spectralis HRA+OCT instrument also was used to measure cpRNFL, and Heidelberg retina tomography II (HRT) and standard automated perimetry (SAP) were performed. Assessments were performed every 3 months over several years. Linear mixed modeling was used to evaluate the rate of change in each measure. Results: Totals of 1406 RTVue, 1366 Spectralis, 1245 HRT, and 1392 SAP measurements were analyzed. Average baseline SAP mean deviation (MD) was a??6.24 ?± 5.46 dB. Linear mixed modeling revealed that SAP MD changed by a??0.23 dB/y (95% confidence interval [CI], a??0.34 to a??0.12 dB/y). Significant negative trends also were detected in cpRNFL (RTVue, a??0.41 ??m/y [95% CI, a??0.67 to a??0.16 ??m/y]; Spectralis, a??1.36 ??m/y [95% CI, a??1.65 to a??1.07 ??m/y]; and mGCC (RTVue, a??0.47 ??m/y [95% CI, a??0.64 to a??0.30 ??m/y]). Disc rim area remained constant over time (HRT, a??0.01 mm2/y [95% CI, a??0.03 to 0.01 mm2/y]). The SAP MD, RTVue mGCC, and Spectralis cpRNFL showed the fastest changes in the inferior retina (superior visual field), while RTVue cpRNFL changed the fastest in the superior retina. Conclusions: Functional (SAP) and structural (SD-OCT) testing can detect longitudinal changes of glaucomatous optic neuropathy, but in different ways.