Comparison of Longitudinal Changes in Functional and Structural Measures for Evaluating Progression of Glaucomatous Optic Neuropathy.
OBJECTIVE
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 -6.24 ± 5.46 dB. Linear mixed modeling revealed that SAP MD changed by -0.23 dB/y (95% confidence interval [CI], -0.34 to -0.12 dB/y). Significant negative trends also were detected in cpRNFL (RTVue, -0.41 μm/y [95% CI, -0.67 to -0.16 μm/y]; Spectralis, -1.36 μm/y [95% CI, -1.65 to -1.07 μm/y]; and mGCC (RTVue, -0.47 μm/y [95% CI, -0.64 to -0.30 μm/y]). Disc rim area remained constant over time (HRT, -0.01 mm2/y [95% CI, -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.
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Kenji
K
Suda
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Masanori
M
Hangai
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Tadamichi
T
Akagi
Department of Data Science, The Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan.
Hisashi
H
Noma
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Yugo
Y
Kimura
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Tomoko
T
Hasegawa
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Hiroshi
H
Yamada
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Munemitsu
M
Yoshikawa
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Hideo
H
Nakanishi
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Hanako Ohashi
HO
Ikeda
Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan.
Nagahisa
N
Yoshimura
D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology* / Q000503:physiopathology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014794:Visual Fields / Q000502:physiology*; D055815:Young Adult