Rate and Pattern of Rim Area Loss in Healthy and Progressing Glaucoma Eyes.

PURPOSE To characterize the rate and pattern of age-related and glaucomatous neuroretinal rim area changes in subjects of African and European descent. DESIGN Prospective longitudinal study. PARTICIPANTS Two hundred ninety-six eyes of 157 healthy subjects (88 patients of African descent and 69 of European descent) and 73 progressing glaucoma eyes of 67 subjects (24 patients of African descent and 43 of European descent) from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study were included. METHODS Global and sectoral rim areas were measured using confocal laser scanning ophthalmoscopy. Masked stereophotograph review determined progression of glaucomatous optic disc damage. The rates of absolute rim area loss and percentage rim area loss in healthy and progressing glaucomatous eyes were compared using multivariate, nested, mixed-effects models. MAIN OUTCOME MEASURES Rate of rim area loss over time. RESULTS The median follow-up time was 5.0 years (interquartile range, 2.0-7.4 years) for healthy eyes and 8.3 years (interquartile range, 7.5-9.9 years) for progressing glaucoma eyes. The mean rate of global rim area loss was significantly faster in progressing glaucomatous eyes compared with healthy eyes for both rim area loss (-10.2×10(-3) vs. -2.8×10(-3) mm(2)/year, respectively; P < 0.001) and percentage rim area loss (-1.1% vs. -0.2%/year, respectively; P < 0.001), but considerable overlap existed between the 2 groups. Sixty-three percent of progressing glaucoma eyes had a rate of change faster than the fifth quantile of healthy eyes. For both healthy and progressing eyes, the pattern of rim area loss and percentage rim area loss were similar, tending to be fastest in the superior temporal and inferior temporal sectors. The rate of change was similar in progressing eyes of patients of African or European descent. CONCLUSIONS Compared with healthy eyes, the mean rate of global rim area loss was 3.7 times faster and the mean rate of global percentage rim area loss was 5.4 times faster in progressing glaucoma eyes. A reference database of healthy eyes can be used to help clinicians distinguish age-related rim area loss from rim area loss resulting from glaucoma.

[1]  P A Sample,et al.  Optic nerve head topography in ocular hypertensive eyes using confocal scanning laser ophthalmoscopy. , 1996, American journal of ophthalmology.

[2]  J. G. Babu,et al.  Normal age-related decay of retinal nerve fiber layer thickness. , 2007, Ophthalmology.

[3]  R. Ramakrishnan,et al.  Retinal nerve fibre layer thickness measurements in normal Indian population by optical coherence tomography. , 2006, Indian journal of ophthalmology.

[4]  Ö. Yılmaz,et al.  Relation of optic disc topography and age to thickness of retinal nerve fibre layer as measured using scanning laser polarimetry, in normal subjects , 2000, The British journal of ophthalmology.

[5]  Stefano Miglior,et al.  Reproducibility of evaluation of optic disc change for glaucoma with stereo optic disc photographs. , 2003, Ophthalmology.

[6]  F. Medeiros,et al.  Prediction of functional loss in glaucoma from progressive optic disc damage. , 2009, Archives of ophthalmology.

[7]  H. Quigley,et al.  Number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. , 2000, Investigative ophthalmology & visual science.

[8]  H. Gao,et al.  Aging of the human retina. Differential loss of neurons and retinal pigment epithelial cells. , 1992, Investigative ophthalmology & visual science.

[9]  C. Girkin,et al.  Differences in optic disc topography between black and white normal subjects. , 2005, Ophthalmology.

[10]  M. C. Leske,et al.  Incidence of open-angle glaucoma: the Barbados Eye Studies. The Barbados Eye Studies Group. , 2001, Archives of ophthalmology.

[11]  A. Sommer Epidemiology, ethnicity, race, and risk. , 2003, Archives of ophthalmology.

[12]  A J Adams,et al.  Optimum Parameters for Short‐Wavelength Automated Perimetry , 1996, Journal of glaucoma.

[13]  B C Chauhan,et al.  Technique for detecting serial topographic changes in the optic disc and peripapillary retina using scanning laser tomography. , 2000, Investigative ophthalmology & visual science.

[14]  J Caprioli,et al.  Progression of disc and field damage in early glaucoma. , 1993, Archives of ophthalmology.

[15]  Douglas R. Anderson,et al.  Determinants of normal retinal nerve fiber layer thickness measured by Stratus OCT. , 2007, Ophthalmology.

[16]  F. Medeiros,et al.  The Relationship between intraocular pressure and progressive retinal nerve fiber layer loss in glaucoma. , 2009, Ophthalmology.

[17]  F. Medeiros,et al.  Evaluation of progressive neuroretinal rim loss as a surrogate end point for development of visual field loss in glaucoma. , 2014, Ophthalmology.

[18]  Robert N Weinreb,et al.  African Descent and Glaucoma Evaluation Study (ADAGES): III. Ancestry differences in visual function in healthy eyes. , 2010, Archives of ophthalmology.

[19]  R. Asaoka,et al.  HRT-3 Moorfields reference plane: effect on rim area repeatability and identification of progression , 2009, British Journal of Ophthalmology.

[20]  A. Harman,et al.  Neuronal density in the human retinal ganglion cell layer from 16–77 years , 2000, The Anatomical record.

[21]  Shu Liu,et al.  Evaluation of retinal nerve fiber layer progression in glaucoma a prospective analysis with neuroretinal rim and visual field progression. , 2011, Ophthalmology.

[22]  G. Wollstein,et al.  Optical coherence tomography longitudinal evaluation of retinal nerve fiber layer thickness in glaucoma. , 2005, Archives of ophthalmology.

[23]  K. A. Townsend,et al.  Effects of age on optical coherence tomography measurements of healthy retinal nerve fiber layer, macula, and optic nerve head. , 2009, Ophthalmology.

[24]  F. Medeiros,et al.  The African Descent and Glaucoma Evaluation Study (ADAGES): predictors of visual field damage in glaucoma suspects. , 2015, American journal of ophthalmology.

[25]  J. Jonas,et al.  Human optic nerve fiber count and optic disc size. , 1992, Investigative ophthalmology & visual science.

[26]  Robert N Weinreb,et al.  Detection of progressive retinal nerve fiber layer loss in glaucoma using scanning laser polarimetry with variable corneal compensation. , 2009, Investigative ophthalmology & visual science.

[27]  L. Zangwill,et al.  Primary open-angle glaucoma in blacks: a review. , 2003, Survey of ophthalmology.

[28]  H A Quigley,et al.  The effect of age on normal human optic nerve fiber number and diameter. , 1989, Ophthalmology.

[29]  M. Shirakashi,et al.  Relation between size of optic disc and thickness of retinal nerve fibre layer in normal subjects , 1998, The British journal of ophthalmology.

[30]  Dong Myung Kim,et al.  Glaucoma Progression After the First-detected Optic Disc Hemorrhage by Optical Coherence Tomography , 2012, Journal of glaucoma.

[31]  F. Medeiros,et al.  African Descent and Glaucoma Evaluation Study (ADAGES): II. Ancestry differences in optic disc, retinal nerve fiber layer, and macular structure in healthy subjects. , 2010, Archives of ophthalmology.

[32]  M. Wilson,et al.  Race, ethnicity and prevalence of primary open-angle glaucoma. , 2006, Journal of the National Medical Association.

[33]  D. Broadway,et al.  A Comparison of Healthy, Ocular Hypertensive, and Glaucomatous Optic Disc Topographic Parameters , 1997, Journal of glaucoma.

[34]  A. Mccormick,et al.  Aging of the optic nerve. , 1980, Archives of ophthalmology.

[35]  Robert N Weinreb,et al.  Performance of confocal scanning laser tomograph Topographic Change Analysis (TCA) for assessing glaucomatous progression. , 2009, Investigative ophthalmology & visual science.

[36]  R A Hitchings,et al.  Aging changes of the optic nerve head in relation to open angle glaucoma , 1997, The British journal of ophthalmology.

[37]  Nicholas G Strouthidis,et al.  Optic disc and visual field progression in ocular hypertensive subjects: detection rates, specificity, and agreement. , 2006, Investigative ophthalmology & visual science.

[38]  Shu Liu,et al.  Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a prospective analysis of age-related loss. , 2012, Ophthalmology.

[39]  B C Chauhan,et al.  Test-retest variability of topographic measurements with confocal scanning laser tomography in patients with glaucoma and control subjects. , 1994, American journal of ophthalmology.

[40]  L. Zangwill,et al.  Discriminating between normal and glaucomatous eyes using the Heidelberg Retina Tomograph, GDx Nerve Fiber Analyzer, and Optical Coherence Tomograph. , 2001, Archives of ophthalmology.

[41]  J Katz,et al.  Racial differences in the cause-specific prevalence of blindness in east Baltimore. , 1991, The New England journal of medicine.

[42]  M. W. Tuck,et al.  The age distribution of primary open angle glaucoma. , 1998, Ophthalmic epidemiology.

[43]  Albert Hofman,et al.  Incidence of open-angle glaucoma in a general elderly population: the Rotterdam Study. , 2005, Ophthalmology.

[44]  D. Garway-Heath,et al.  Factors affecting the test-retest variability of Heidelberg retina tomograph and Heidelberg retina tomograph II measurements , 2005, British Journal of Ophthalmology.

[45]  M. Kass,et al.  The rate of structural change: the confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study. , 2013, American journal of ophthalmology.

[46]  Makoto Nakamura,et al.  Evaluation of the Effect of Aging on Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography , 2003, Ophthalmologica.

[47]  G. Wollstein,et al.  Variation in optic nerve and macular structure with age and race with spectral-domain optical coherence tomography. , 2011, Ophthalmology.

[48]  Robert N Weinreb,et al.  The African Descent and Glaucoma Evaluation Study (ADAGES): design and baseline data. , 2009, Archives of ophthalmology.

[49]  R. Weinreb,et al.  Impact of age-related change of retinal nerve fiber layer and macular thicknesses on evaluation of glaucoma progression. , 2013, Ophthalmology.

[50]  M. Kass,et al.  Racial differences in optic disc topography: baseline results from the confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study. , 2004, Archives of ophthalmology.

[51]  R. Weinreb Laser scanning tomography to diagnose and monitor glaucoma. , 1993, Current opinion in ophthalmology.

[52]  J. Moreno-Montañés,et al.  Agreement among spectral-domain optical coherence tomography, standard automated perimetry, and stereophotography in the detection of glaucoma progression. , 2015, Investigative ophthalmology & visual science.

[53]  C. Cheung,et al.  Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography a study on diagnostic agreement with Heidelberg Retinal Tomograph. , 2010, Ophthalmology.

[54]  Robert N Weinreb,et al.  Impact of atypical retardation patterns on detection of glaucoma progression using the GDx with variable corneal compensation. , 2009, American journal of ophthalmology.

[55]  F. Medeiros,et al.  Agreement for detecting glaucoma progression with the GDx guided progression analysis, automated perimetry, and optic disc photography. , 2010, Ophthalmology.

[56]  F. J. Moya,et al.  Effect of aging on optic nerve appearance: a longitudinal study , 1999, The British journal of ophthalmology.

[57]  C. Nievergelt,et al.  Biogeographic Ancestry in the African Descent and Glaucoma Evaluation Study (ADAGES): Association With Corneal and Optic Nerve Structure. , 2015, Investigative ophthalmology & visual science.

[58]  M. Wilson The use of "race" for classification in medicine: is it valid? , 2003, Journal of glaucoma.

[59]  H. Taylor,et al.  Five-year incidence of open-angle glaucoma: the visual impairment project. , 2002, Ophthalmology.

[60]  M. Nicolela,et al.  Rates of neuroretinal rim and peripapillary atrophy area change: a comparative study of glaucoma patients and normal controls. , 2009, Ophthalmology.

[61]  F. Medeiros,et al.  Determinants of agreement between the confocal scanning laser tomograph and standardized assessment of glaucomatous progression. , 2010, Ophthalmology.

[62]  A. Tuulonen,et al.  Rate and pattern of neuroretinal rim area decrease in ocular hypertension and glaucoma. , 1992, Archives of ophthalmology.