Detecting the Progression of Normal Tension Glaucoma: A Comparison of Perimetry, Optic Coherence Tomography, and Heidelberg Retinal Tomography

Yoon, Jae-Yoon; Na, Jong Kyung; Park, Chan Kee

doi:10.3341/kjo.2015.29.1.31

Cited by 4 publications

(3 citation statements)

References 25 publications

(35 reference statements)

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“…Visual field testing is basically the device for determine progression by which other instruments are measured. Perimetry detects progression at a greater rate, than HRT or OCT, likewise in our cohort, especially in eyes with advanced NTG [26] . This study was based on a large dataset with a high number of examinations, similar to those in large multicenter studies.…”

Section: Discussionmentioning

confidence: 48%

Impact of intraocular pressure fluctuations on progression of normal tension glaucoma

Hopf¹,

Schmidtmann²,

Pfeiffer³

2021

Int J Ophthalmol

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AIM: To investigate short- and long-term intraocular pressure (IOP) fluctuations and further ocular and demographic parameters as predictors for normal tension glaucoma (NTG) progression. METHODS: This retrospective, longitudinal cohort study included 137 eyes of 75 patients with NTG, defined by glaucomatous optic disc or visual field defect with normal IOP (<21 mm Hg), independently from therapy regimen. IOP fluctuation, mean, and maximum were inspected with a mean follow-up of 38mo [standard deviation (SD) 18mo]. Inclusion criteria were the performance of minimum two 48-hour profiles including perimetry, Heidelberg retina tomograph (HRT) imaging, and optic disc photographs. The impact of IOP parameters, myopia, sex, cup-to-disc-ratio, and visual field results on progression of NTG were analyzed using Cox regression models. A sub-group analysis with results from optical coherence tomography (OCT) was performed. RESULTS: IOP fluctuations, average, and maximum were not risk factors for progression in NTG patients, although maximum IOP at the initial IOP profile was higher in eyes with progression than in eyes without progression (P=0.054). The 46/137 (33.5%) eyes progressed over the follow-up period. Overall progression (at least three progression confirmations) occurred in 28/137 eyes (20.4%). Most progressions were detected by perimetry (36/46). Long-term IOP mean over all pressure profiles was 12.8 mm Hg (SD 1.3 mm Hg); IOP fluctuation was 1.4 mm Hg (SD 0.8 mm Hg). The progression-free five-year rate was 58.2% (SD 6.5%). CONCLUSION: Short- and long-term IOP fluctuations do not result in progression of NTG. As functional changes are most likely to happen, NTG should be monitored with visual field testing more often than with other devices.

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Section: Discussionmentioning

confidence: 48%

Impact of intraocular pressure fluctuations on progression of normal tension glaucoma

Hopf¹,

Schmidtmann²,

Pfeiffer³

2021

Int J Ophthalmol

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“…The ROC of RNFL in Asian (Korean) cohorts including predominantly NTG with early stage (baseline mean deviation, MD: −2.48 ± 4.46 dB) has been shown to be −0.71 (−0.94; −0.48) µm/yr [ 16 ]. In another study on moderate stage of NTG (baseline MD: −8.49 ± 7.63 dB in progressed group, −8.13 ± 9.58 dB in non-progressed group) in Asian (Korean) subjects, the ROC of RNFL was −0.39 ± 0.24 µm/yr in progressed group and −0.07 ± 0.29 µm/yr in non-progressed group [ 17 ]. Considering the relatively small ROC of RNFL, which is less than −1.0 µm/yr in Asian cohorts with NTG predominance, early detection of glaucomatous deterioration with subtle change of RNFL in clinical situation may be difficult.…”

Section: Introductionmentioning

confidence: 99%

Rate of Change in Bruch’s Membrane Opening-Minimum Rim Width and Peripapillary RNFL in Early Normal Tension Glaucoma

Cho

Kee

2020

JCM

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Background: to investigate the rate of change (ROC) of Bruch’s membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness in early normal tension glaucoma (NTG) patients. Methods: in this longitudinal cohort study, 115 subjects (115 eyes) diagnosed as early NTG (mean deviation > −6.0 dB) and who had completed more than five times of spectral-domain optical coherence tomography (OCT) tests with acceptable quality were included. Measurement of BMO-MRW and RNFL were performed at 3-month intervals by OCT. Linear mixed-effects model was employed to calculate the ROC in global region and six Garway-Heath sectors with adjusting age, sex, and BMO area. Results: Average follow-up was 20.99 ± 6.99 months with OCT number of 7.54 ± 2.12. Baseline intraocular pressure was 14.72 ± 2.70 mmHg and MD was −2.73 ± 2.26 dB. ROC of global BMO-MRW was −2.06 ± 0.65 µm/yr and RNFL was −0.96 ± 0.16 µm/yr (p = 0.098). The most rapid ROC was in inferotemporal sector (BMO-MRW: −3.02 ± 0.88 µm/yr, RNFL: −1.96 ± 0.36 µm/yr) followed by superotemporal sector. Conclusion: The ROC of BMO-MRW, the new parameter along with that of RNFL should be considered in the management of early NTG. BMO-MRW may show visible reduction ROC better than RNFL to detect early progression in early NTG when visual field may not show significant change.

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“…Spectral domain optical coherence tomography (SD-OCT) allows visualization of the cross-sectional structure of retina in vivo. 7 It is now widely being used to investigate the pathogenesis, diagnosis, and management of many diseases such as retinal vein occlusion, 8 age-related macular degeneration, 9 glaucoma, 10 central serous chorioretinopathy, 11 and diabetic retinopathy. 12 SD-OCT has also been used to investigate the structural changes in endophthalmitis.…”

Section: Introductionmentioning

confidence: 99%

Atrophy of retinal inner layers is associated with poor vision after endophthalmitis: a spectral domain optical coherence tomography study

Chen

et al. 2017

Eye

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PurposeTo investigate the retinal structural changes in endophthalmitis and their association with visual outcome.Patients and methodsForty-five eyes of 45 patients diagnosed with endophthalmitis were included. Spectral domain optical coherence tomography (SD-OCT) was performed after inflammation was controlled. The relationship between SD-OCT features and best-corrected visual acuity (BCVA) at the last follow-up was analyzed.ResultsThe structural changes included inner segment ellipsoid (ISe) disruption (49%), atrophy of retinal inner layers (24%), epimacular membrane (24%), and macular edema (24%). BCVA was worse in patients with ISe disruption (P=0.005) and retinal inner layers' atrophy (P=0.004) compared with those without. There was no significant difference of BCVA between the patients with and without epimacular membrane, or intraretinal cysts. Multivariate regression showed that atrophy of retinal inner layers (b=0.41±0.17, P=0.022) was the only independent factor associated with BCVA.ConclusionAtrophy of retinal inner layers is associated with visual impairment in endophthalmitis, despite successful management.

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Detecting the Progression of Normal Tension Glaucoma: A Comparison of Perimetry, Optic Coherence Tomography, and Heidelberg Retinal Tomography

Cited by 4 publications

References 25 publications

Impact of intraocular pressure fluctuations on progression of normal tension glaucoma

Impact of intraocular pressure fluctuations on progression of normal tension glaucoma

Rate of Change in Bruch’s Membrane Opening-Minimum Rim Width and Peripapillary RNFL in Early Normal Tension Glaucoma

Atrophy of retinal inner layers is associated with poor vision after endophthalmitis: a spectral domain optical coherence tomography study

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