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

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dc.contributor.authorMeira-Freitas, Daniel [UNIFESP]
dc.contributor.authorLisboa, Renato [UNIFESP]
dc.contributor.authorTatham, Andrew
dc.contributor.authorZangwill, Linda M.
dc.contributor.authorWeinreb, Robert N.
dc.contributor.authorGirkin, Christopher A.
dc.contributor.authorLiebmann, Jeffrey M.
dc.contributor.authorMedeiros, Felipe Andrade [UNIFESP]
dc.contributor.institutionUniv Calif San Diego
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Alabama Birmingham
dc.contributor.institutionNew York Eye & Ear Infirm
dc.date.accessioned2016-01-24T14:31:49Z
dc.date.available2016-01-24T14:31:49Z
dc.date.issued2013-06-01
dc.description.abstractPURPOSE. 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.en
dc.description.affiliationUniv Calif San Diego, Hamilton Glaucoma Ctr, La Jolla, CA 92093 USA
dc.description.affiliationUniv Calif San Diego, Dept Ophthalmol, La Jolla, CA 92093 USA
dc.description.affiliationUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, Brazil
dc.description.affiliationUniv Alabama Birmingham, Dept Ophthalmol, Birmingham, AL 35294 USA
dc.description.affiliationNew York Eye & Ear Infirm, Dept Ophthalmol, New York, NY 10003 USA
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNational Institutes of Health/National Eye Institute
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipResearch to Prevent Blindness (New York, New York)
dc.description.sponsorshipAlcon
dc.description.sponsorshipAllergan
dc.description.sponsorshipPfizer
dc.description.sponsorshipMerck
dc.description.sponsorshipSanten
dc.description.sponsorshipIDNational Institutes of Health/National Eye Institute: EY021818
dc.description.sponsorshipIDNational Institutes of Health/National Eye Institute: EY11008
dc.description.sponsorshipIDNational Institutes of Health/National Eye Institute: EY14267
dc.description.sponsorshipIDCNPq: 200178/2012-1
dc.format.extent4174-4183
dc.identifierhttp://dx.doi.org/10.1167/iovs.12-11301
dc.identifier.citationInvestigative Ophthalmology & Visual Science. Rockville: Assoc Research Vision Ophthalmology Inc, v. 54, n. 6, p. 4174-4183, 2013.
dc.identifier.doi10.1167/iovs.12-11301
dc.identifier.issn0146-0404
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/36368
dc.identifier.wosWOS:000321120700045
dc.language.isoeng
dc.publisherAssoc Research Vision Ophthalmology Inc
dc.relation.ispartofInvestigative Ophthalmology & Visual Science
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectglaucomaen
dc.subjectvisual fielden
dc.subjectoptical coherence tomographyen
dc.subjectoptic nerve headen
dc.subjectintraocular pressureen
dc.titlePredicting Progression in Glaucoma Suspects With Longitudinal Estimates of Retinal Ganglion Cell Countsen
dc.typeinfo:eu-repo/semantics/article
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