Predicting Development of Glaucomatous Visual Field Conversion Using Baseline Fourier-Domain Optical Coherence Tomography

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• 作者：Xinbo Zhang^a ; Nils Loewen^b ; Ou Tan^a ; David S. Greenfield^c ; Joel S. Schuman^b ; Rohit Varma^d ; David Huang^a ; ^{davidhuang@alum.mit.edu" class="auth_mail" title="E-mail the corresponding author} ; the Advanced Imaging for Glaucoma Study GroupDavid Huang ; MD ; PhD ; Brian Francis ; MD ; David S. Greenfield ; MD ; Richard K. Parrish II ; MD ; Joel S. Schuman ; MD ; Rohit Varma ; MD ; MPH ; Krishna S. Kishor ; MD ; Carolyn D. Quinn ; MD ; Shawn Iverson ; DO ; Nayara Kish ; BS ; CCRC ; Jose Rebimbas ; BS ; CCRC ; Debra Weiss ; CRC ; Vikas Chopra ; MD ; John Gil-Flamer ; COT ; Judith Linton ; COA ; Sylvia Ramos ; CCRP ; Eiyass Albeiruti ; MD ; Nils Loewen ; MD ; Robert Noecker ; MD ; Michael DeRosa ; BS ; BA ; Greg Owens ; BA ; CCRP ; Melessa Salay ; BA ; Kristy Truman ; COA ; Janice Ladwig ; COT ; CCRP ; Michelle Montalto ; BS ; Hiroshi Ishikawa ; MD ; Larry Kagemann ; MS ; Mitra Sehi ; PhD ; Ou Tan ; PhD ; Yimin Wang ; PhD ; Gadi Wollstein ; MD ; Sharon Bi ; MCIS ; Swati Chakraborty ; MS ; Robert DiLaura ; MBA ; DBA ; Bo Hu ; PhD ; John Sell ; Eleonore Savatovsky ; PhD ; Srinivas R. Sadda ; MD ; Ranjith Konduru ; MD ; Elnaz Rakhshan ; MD ; Sowmya Srinivas ; MBBS ; Ake T.H. Lu ; PhD ; Xinbo Zhang ; PhD
• 刊名：American Journal of Ophthalmology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：163
• 期：Complete
• 页码：29-37
• 全文大小：404 K

文摘

To predict the development of glaucomatous visual field (VF) defects using Fourier-domain optical coherence tomography (FD OCT) measurements at baseline visit.

Design

Multicenter longitudinal observational study. Glaucoma suspects and preperimetric glaucoma participants in the Advanced Imaging for Glaucoma Study.

Methods

The optic disc, peripapillary retinal nerve fiber layer (NFL), and macular ganglion cell complex (GCC) were imaged with FD OCT. VF was assessed every 6 months. Conversion to perimetric glaucoma was defined by VF pattern standard deviation (PSD) or glaucoma hemifield test (GHT) outside normal limits on 3 consecutive tests. Hazard ratios were calculated with the Cox proportional hazard model. Predictive accuracy was measured by the area under the receiver operating characteristic curve (AUC).

Results

Of 513 eyes (309 participants), 55 eyes (46 participants) experienced VF conversion during 41 ± 23 months of follow-up. Significant (P < .05, Cox regression) FD OCT risk factors included all GCC, NFL, and disc variables, except for horizontal cup-to-disc ratio. GCC focal loss volume (FLV) was the best single predictor of conversion (AUC = 0.753, P < .001 for test against AUC = 0.5). Those with borderline or abnormal GCC-FLV had a 4-fold increase in conversion risk after 6 years (Kaplan-Meier). Optimal prediction of conversion was obtained using the glaucoma composite conversion index (GCCI) based on a multivariate Cox regression model that included GCC-FLV, inferior NFL quadrant thickness, age, and VF PSD. GCCI significantly improved predictive accuracy (AUC = 0.783) over any single variable (P = .04).

Conclusions

Reductions in NFL and GCC thickness can predict the development of glaucomatous VF loss in glaucoma suspects and preperimetric glaucoma patients.