title: Reduction of posterior pole retinal thickness in glaucoma detected using the Retinal Thickness Analyzer.
abstract: OBJECTIVE
  To report evidence of changes in posterior pole retinal thickness in glaucoma and preperimetric glaucoma.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  One hundred forty participants (140 eyes): 31 normal subjects, 33 with ocular hypertension, 43 with primary open-angle glaucoma (POAG), and 33 with preperimetric glaucoma.
  
  
  METHODS
  Posterior pole retinal thickness measurements using the Retinal Thickness Analyzer (RTA; Talia Technology Ltd., Neve-Ilan, Israel).
  
  
  METHODS
  The mean foveola average thickness (VAV), foveola minimum thickness (VMI), perifoveal average thickness (PFAV), perifoveal minimum thickness (PFMI), posterior pole average thickness (PPAV), and posterior pole minimum thickness (PPMI) were compared among the groups. The correlation between RTA values and visual field values was evaluated. The area under the receiver operator characteristic (AROC) curve, the optimal cut values, and the predictability values were estimated statistically between normal and the other groups using RTA values.
  
  
  RESULTS
  Results from 91 eyes (65%) were included. Perifoveal average thickness values in preperimetric glaucoma (190.4+/-15.6 microm; mean+/-standard deviation) and POAG (185.7+/-16.8 microm) were significantly less than in normal controls (211.4+/-16.8 microm) and in eyes with ocular hypertension (211.6+/-15.9 microm). Perifoveal minimum thickness, PPAV, and PPMI were significantly less in preperimetric glaucoma and in POAG than in normal controls; VAV and VMI were not significantly different among groups. Perifoveal average thickness, PFMI, PPAV, and PPMI significantly correlated with visual field mean defect (R = -0.38, -0.42, -0.36, and -0.41, respectively) and loss of variance (R = -0.29, -0.30, -0.26, and -0.17, respectively). The AROC using PFAV, PFMI, PPAV, and PPMI was significantly larger than 0.5 between normal and preperimetric glaucoma (0.83, 0.92, 0.82, and 0.87, respectively) and between normal and POAG eyes (0.86, 0.97, 0.83, and 0.93, respectively). When using the PFMI, the sensitivities at the minimum specificity cutoffs of 90% were highest in comparisons between normal and preperimetric glaucoma (sensitivity, 75%) and between normal and POAG eyes (sensitivity, 95%). By the logistic regression analysis, PFAV, PFMI, PPAV, and PPMI distinguished between normal and preperimetric glaucoma (R(2) = 0.30, 0.49, 0.27, and 0.37, respectively) and between normal and POAG (R(2) = 0.37, 0.59, 0.31, and 0.51, respectively).
  
  
  CONCLUSIONS
  Posterior pole retinal thickness decreases in early- and moderate-stage glaucoma. Reduction of perifoveal retinal thickness is correlated with visual field loss. In vivo measurements of posterior pole retinal thickness may help distinguish between normal and glaucomatous eyes.
authors.affiliation: Sensho-kai Eye Institute, Kyoto, Japan. tanito-oph@umin.ac.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanito
authors.forename: Noriko
authors.initials: N
authors.lastname: Itai
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ohira
authors.forename: Etsuo
authors.initials: E
authors.lastname: Chihara
mesh_terms: D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis; D011237:Predictive Value of Tests; D012160:Retina / Q000473:pathology*; D012680:Sensitivity and Specificity; D014786:Vision Disorders / Q000175:diagnosis*; D014794:Visual Fields