From Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA (L.S, M.M, V.M, J.C, K.N-M).
Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA (E.S, R.E.W).
Am J Ophthalmol. 2023 Sep;253:181-188. doi: 10.1016/j.ajo.2023.05.003. Epub 2023 May 6.
To compare rates of change (RoC) of peripapillary retinal nerve fiber layer (RNFL) and Bruch membrane opening-based minimum rim width (BMO-MRW) thickness in moderate-to-advanced glaucoma.
Prospective cohort study.
Longitudinal optical coherence tomography (OCT) optic nerve head volume scans of 113 eyes of 113 glaucoma patients with moderate-to-advanced or central damage were exported. This study estimated and compared global and sectoral RoC with linear mixed effects models and simple linear regression (SLR) of RNFL and BMO-MRW thickness. Permutation analyses were used to test significance of RoC in the SLR model. It also compared longitudinal signal-to-noise ratios (LSNR) defined as RoC divided by residual standard deviation (SD) between the two groups.
Mean (SD) follow-up and median (IQR) OCT scan sessions were 5.2 (1.3) years and 10 (8-11), respectively. Baseline average (SD) visual field mean deviation was -9.2 (5.8) dB. Based on SLR, a higher proportion of significant negative RNFL RoC was observed compared to BMO-MRW in the inferotemporal (35% vs 20%; P = .015) and inferonasal (42% vs 17%; P < .001) sectors. Permutation analyses also demonstrated a higher proportion of worsening RNFL RoC than BMO-MRW in the inferotemporal (P = .026) and inferonasal (P < .001) sectors along with overall lower positive RoC. Longitudinal signal-to-noise ratios for RNFL were significantly more negative than for BMO-MRW globally, and in the inferotemporal, inferonasal, and superonasal sectors (P ≤ .01).
Longitudinal RNFL OCT measurements are more likely to detect structural change and demonstrate better LSNR compared with BMO-MRW in eyes with central or moderate-to-advanced glaucoma damage at baseline.
比较中晚期青光眼患者视盘周围视网膜神经纤维层（RNFL）和脉络膜开口最小边缘宽度（BMO-MRW）厚度的变化率（RoC）。
前瞻性队列研究。
导出 113 例中晚期或中心损伤青光眼患者的 113 只眼的长轴向光学相干断层扫描（OCT）视神经头容积扫描。本研究使用线性混合效应模型和 RNFL 和 BMO-MRW 厚度的简单线性回归（SLR）来估计和比较全局和扇形 RoC。置换分析用于测试 SLR 模型中 RoC 的显著性。它还比较了定义为 RoC 除以两组之间剩余标准差（SD）的纵向信噪比（LSNR）。
平均（SD）随访和中位数（IQR）OCT 扫描时间分别为 5.2（1.3）年和 10（8-11）。基线平均（SD）视野平均偏差为-9.2（5.8）dB。基于 SLR，与 BMO-MRW 相比，在颞下（35%对 20%；P=0.015）和颞下（42%对 17%；P<0.001）象限中观察到更高比例的显著负 RNFL RoC。置换分析还表明，在颞下（P=0.026）和颞下（P<0.001）象限中，RNFL RoC 的恶化比例高于 BMO-MRW，整体正 RoC 较低。RNFL 的纵向信噪比明显低于 BMO-MRW，无论是在全局，还是在颞下、颞下和鼻上象限（P≤0.01）。
与 BMO-MRW 相比，在基线时具有中心或中晚期青光眼损伤的眼中，RNFL OCT 纵向测量更有可能检测到结构变化，并显示出更好的 LSNR。
