Localized Changes in Retinal Nerve Fiber Layer Thickness as a Predictor of Localized Functional Change in Glaucoma

Abstract

Purpose To determine how well rates of localized retinal nerve fiber layer thickness (RNFLT) change correlate with rates of sensitivity change at corresponding locations in the visual field in glaucoma. Design Retrospective Cohort Study Methods 364 eyes of 191 participants, with suspected or confirmed glaucoma as judged by experienced clinicians, were tested every six months with perimetry and optical coherence tomography (OCT). For each 24-2 visual field location, the corresponding sectoral peripapillary RNFLT was defined using a 30° sector, centered on the angle of nerve fiber entry into the optic nerve head. Rates of change of pointwise sensitivity and sectoral RNFLT were calculated over the last 8 visits at which reliable data were obtained. Passing-Bablok regression was used to predict the rate of pointwise sensitivity change from the rate of sectoral RNFLT change, for each location. Results Rates of sectoral RNFLT change were significantly predictive of rates of pointwise sensitivity change at all locations in the field. Correlations were modest, averaging 0.15, ranging from 0.03 to 0.25 depending on the location. A 1μm/y more rapid thinning in corresponding sectors was associated with 0.3dB/y more rapid loss in the superior visual field, but less than 0.1dB more rapid loss at many locations in the inferior visual field. Conclusions Localized RNFL thinning is associated with sensitivity loss at corresponding locations in the visual field, and their rates of change are significantly correlated. Peripapillary RNFLT may be used to monitor localized changes caused by glaucoma that have measurable consequences for a patient's vision.

The Impact of Lens Opacity on SD-OCT Retinal Nerve Fiber Layer and Bruch's Membrane Opening Measurements Using the Anatomical Positioning System (APS)

“…Analyses of RNFLT are frequently used in glaucoma diagnostics [1][2][3] and hold promise as a biomarker for various neurodegenerative diseases. 4,5 Alterations and thinning of different retinal layers have been associated with neurologic diseases such as multiple sclerosis or Parkinson's disease.…”

Association of Birth Weight with Peripapillary Retinal Nerve Fiber Layer Thickness in Adulthood—Results from a Population-Based Study

“…36 Additionally, progression of glaucoma is most frequently located in the inferotemporal sector of the pRNFL, 34 and pRNFL thinning is linked to several optic neuropathies. 34,[37][38][39] Consequently, low birth weight may be a previously unknown risk factor, among others, predisposing for these diseases, including glaucoma. This suggestion should be explored further to identify fetal origins of important adult eye diseases.…”

Systemic and Ocular Determinants of Peripapillary Retinal Nerve Fiber Layer Thickness Measurements in the European Eye Epidemiology (E3) Population

“…The assessment of peripapillary retinal nerve fiber layer thickness (pRNFLT) with Spectral -Domain Optical Coherence Tomography (SD-OCT) has become of increasing importance in the evaluation of glaucoma and its progression 1,2 . Although debated, pRNFLT measurements hold promise as a biomarker for neurodegenerative diseases such as Alzheimer's disease (AD) and multiple sclerosis (MS) 3,4 .…”