Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields

Abstract

The thicknesses of the circumpapillary retinal nerve fiber layer (cpRNFL) and ganglion cell complex (GCC) did not change during 5 years in physiological large disc cupping.Purpose: We evaluated longitudinal changes in the thicknesses of the cpRNFL and GCC in large disc cupping with a normal intraocular pressure (IOP) (< 21 mm Hg) and visual field.Methods: This retrospective, consecutive case series study included 269 eyes of 269 patients with large disc cupping and normal IOP. We analyzed patient demographics, IOP, central corneal thickness, vertical cup-to-disc ratios using color fundus photography, the thicknesses of the cpRNFL and GCC using RTVue-100, and mean deviation using visual field examinations.Results: The differences in IOP, vertical cup-to-disc ratios, and mean deviation between the baseline and each follow-up visit were not statistically significant. The baseline average and mean average at 60 months follow-up of the cpRNFL thickness were 106.5 ± 8.5 and 105.1 ± 9.3 μm, respectively; differences between the baseline and each follow-up visit were not statistically significant. The baseline average and mean average at 60 months follow-up of the GCC thickness were 82.8 ± 9. and 81.5 ± 9.2 μm, respectively; differences between baseline and each follow-up visit were not statistically significant. Conclusions:The thicknesses of the cpRNFL and GCC did not change in well-maintained optic nerve head findings with normal IOP and visual field during a 5-year follow-up period. Optical coherence tomography evaluations of the thicknesses of the cpRNFL and GCC help accurately diagnose physiological optic disc cupping.

Response to the Letter to the Editor: Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields

“…We appreciate Vieira and colleagues for their interest in our recently published paper 1 in the Journal of Glaucoma and thank them for their insightful comments.…”

Letter to the Editor: Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields

“…We read with great interest the recently published article by Kang and Jin 1 which longitudinally analyzed circumpapillary retinal nerve fiber layer (cpRNFL) and ganglion cell complex (GCC) thicknesses in patients with large optic disc cups but with normal visual fields and intraocular pressure within the normal limits. We believe this is an interesting topic as, although we have detailed information about the natural history of both glaucoma patients and healthy individuals, 2 there are scant data when it comes to how these eyes with presumed large physiological optic disc cupping change over time.…”