Predicting Progression in Glaucoma Suspects With Longitudinal Estimates of Retinal Ganglion Cell Counts

Predicting Progression in Glaucoma Suspects With Longitudinal Estimates of Retinal Ganglion Cell Counts

Author Meira-Freitas, Daniel Autor UNIFESP Google Scholar
Lisboa, Renato Autor UNIFESP Google Scholar
Tatham, Andrew Google Scholar
Zangwill, Linda M. Google Scholar
Weinreb, Robert N. Google Scholar
Girkin, Christopher A. Google Scholar
Liebmann, Jeffrey M. Google Scholar
Medeiros, Felipe Andrade Autor UNIFESP Google Scholar
Institution Univ Calif San Diego
Universidade Federal de São Paulo (UNIFESP)
Univ Alabama Birmingham
New York Eye & Ear Infirm
Abstract PURPOSE. We evaluated the ability of baseline and longitudinal estimates of retinal ganglion cell (RGC) counts in predicting progression in eyes suspected of having glaucoma.METHODS. the study included 288 glaucoma suspect eyes of 288 patients followed for an average of 3.8 +/- 1.0 years. Participants had normal standard automated perimetry (SAP) at baseline. Retinal nerve fiber layer thickness assessment was performed with optical coherence tomography (OCT). Progression was defined as development of repeatable abnormal SAP or glaucomatous progressive optic disc changes. Estimates of RGC counts were obtained by combining data from SAP and OCT according to a previously described method. Joint longitudinal survival models were used to evaluate the ability of baseline and rates of change in estimated RGC counts for predicting progression over time, adjusting for confounding variables.RESULTS. A total of 48 eyes (17%) showed progression during follow-up. the mean rate of change in estimated RGC counts was -18,987 cells/y in progressors versus -8,808 cells/y for nonprogressors (P < 0.001). Baseline RGC counts and slopes of RGC loss were significantly predictive of progression, with HRs of 1.56 per 100,000 cells lower (95% confidence interval [CI], 1.18-2.08; P = 0.002) and 2.68 per 10,000 cells/y faster loss (95% CI, 1.22-5.90; P = 0.014), respectively. the longitudinal model including estimates of RGC counts performed significantly better than models including only structural or functional indexes separately.CONCLUSIONS. Baseline and longitudinal estimates of RGC counts may be helpful in predicting progression and performed significantly better than conventional approaches for risk stratification of glaucoma suspects.
Keywords glaucoma
visual field
optical coherence tomography
optic nerve head
intraocular pressure
Language English
Sponsor National Institutes of Health/National Eye Institute
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Research to Prevent Blindness (New York, New York)
Alcon
Allergan
Pfizer
Merck
Santen
Grant number National Institutes of Health/National Eye Institute: EY021818
National Institutes of Health/National Eye Institute: EY11008
National Institutes of Health/National Eye Institute: EY14267
CNPq: 200178/2012-1
Date 2013-06-01
Published in Investigative Ophthalmology & Visual Science. Rockville: Assoc Research Vision Ophthalmology Inc, v. 54, n. 6, p. 4174-4183, 2013.
ISSN 0146-0404 (Sherpa/Romeo, impact factor)
Publisher Assoc Research Vision Ophthalmology Inc
Extent 4174-4183
Origin http://dx.doi.org/10.1167/iovs.12-11301
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000321120700045
URI http://repositorio.unifesp.br/handle/11600/36368

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