Rapid initial OCT RNFL thinning is predictive of faster visual field loss during extended follow-up in glaucoma.
Rapid initial OCT RNFL thinning is predictive of faster visual field loss during extended follow-up in glaucoma.
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快速初始OCT RNFL变薄可预测青光眼延长随访期间更快的视野丧失。
DOI：
10.1016/j.ajo.2021.03.019
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发表时间：
2021-09
影响因子：
4.2
通讯作者：
Medeiros FA
中科院分区：
文献类型：
--
作者：
Swaminathan SS;Jammal AA;Berchuck SI;Medeiros FA
研究初始随访期间视网膜神经纤维层（RNFL）丢失率与延长随访期间相关视野丢失幅度之间的关系。回顾性队列研究。从杜克青光眼登记处提取了839例青光眼患者的共1，150只眼。从前5次光学相干断层扫描（OCT）的全局RNFL厚度值获得RNFL损失率。在整个随访期间，使用标准自动视野检查平均偏差（SAP MD）评估视野丧失率。联合纵向混合效应模型用于估计变化率。根据RNFL损失率将眼睛分为快速，中度或缓慢进展者，分别为≤−2 μm/年，−2至−1 μm/年和≥−1 μm/年。完成单变量和多变量回归分析，以确定SAP MD丢失的重要预测因素。在初始随访期间，RNFL的变化率为-0.76 ±0.85 μm/y，发生时间超过3.7±1.5年。765只眼（66%）为缓慢进展者，328只眼（29%）为中度进展者，57只眼（5%）为快速进展者，RNFL变薄率分别为−0.36±0.54 μm/年、−1.34±0.25 μm/年和−2.87±1.39 μm/年。在6.1±1.9年的延长随访期内，缓慢、中度和快速OCT进展者的SAP MD丢失率分别为−0.16±0.35 dB/y、−0.32±0.43 dB/y和−0.71±0.65 dB/y（P<0.001）。在多变量模型中，年龄、OCT进展组和并发SAP率均与SAP MD丢失的总体发生率显著相关（均P<0.001）。在最初的随访期内，RNFL的快速变薄可以预测在较长时间内并发和随后的视野下降率。在青光眼患者的初始随访期间，视网膜神经纤维层迅速变薄与整个随访期间的大幅度视野丧失相关。与缓慢进展者相比，在随访过程中早期检测到的光学相干断层扫描快速进展的眼睛在整个随访期间的周边损失率快约4倍。
To investigate the relationship between the rate of retinal nerve fiber layer (RNFL) loss during initial follow-up and the magnitude of associated visual field loss during an extended follow-up period. Retrospective cohort study. A total of 1,150 eyes of 839 glaucoma patients extracted from the Duke Glaucoma Registry. Rates of RNFL loss were obtained from global RNFL thickness values of the first 5 optical coherence tomography (OCT) scans. Rates of visual field loss were assessed using standard automated perimetry mean deviation (SAP MD) during the entire follow-up period. Joint longitudinal mixed effects models were used to estimate rates of change. Eyes were categorized as fast, moderate or slow progressors based on rates of RNFL loss, with cutoffs of ≤−2 μm/year, −2 to −1 μm/year and ≥−1 μm/year, respectively. Univariable and multivariable regressions were completed to identify significant predictors of SAP MD loss. The rate of RNFL change was −0.76±0.85 μm/y during initial follow-up, which occurred over 3.7±1.5 years. 765 (66%) eyes were slow, 328 (29%) moderate, and 57 (5%) fast progressors, with rates of RNFL thinning of −0.36±0.54 μm/year, −1.34±0.25 μm/year, and −2.87±1.39 μm/year respectively. The rates of SAP MD loss among slow, moderate, and fast OCT progressors were −0.16±0.35 dB/y, −0.32±0.43 dB/y, and −0.71±0.65 dB/y respectively over the extended follow-up period of 6.1±1.9 years (P<0.001). Age, OCT progressor group, and concurrent SAP rate were all significantly associated with the overall rate of SAP MD loss in a multivariable model (all P<0.001). Rapid RNFL thinning during an initial follow-up period was predictive of concurrent and subsequent rates of visual field decline over an extended period. Rapid retinal nerve fiber layer thinning during the initial follow-up period of an eye with glaucoma was associated with a large magnitude of visual field loss during the total follow-up period. Compared to slow progressors, eyes with fast progression on optical coherence tomography detected early in the course of follow-up had approximately 4 times faster rates of perimetric loss during the total follow-up period.
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影响因子：
4.2
作者：
Sehi, Mitra;Zhang, Xinbo;Greenfield, David S.;Chung, Yunsuk;Wollstein, Gadi;Francis, Brian A.;Schuman, Joel S.;Varma, Rohit;Huang, David
通讯作者：
Huang, David
影响因子：
13.7
作者：
Diniz-Filho A;Abe RY;Zangwill LM;Gracitelli CP;Weinreb RN;Girkin CA;Liebmann JM;Medeiros FA
通讯作者：
Medeiros FA
影响因子：
4.4
作者：
Patel, Nimesh B.;Lim, Mimi;Harwerth, Ronald S.
通讯作者：
Harwerth, Ronald S.
影响因子：
13.7
作者：
Leite, Mauro T.;Rao, Harsha L.;Medeiros, Felipe A.
通讯作者：
Medeiros, Felipe A.
影响因子：
13.7
作者：
Wu, Zhichao;Saunders, Luke J.;Medeiros, Felipe A.
通讯作者：
Medeiros, Felipe A.