Progression of Visual Field Defects in Eyes With Different Optic Disc Appearances in Patients With Normal Tension Glaucoma

Nakazawa, Toru; Shimura, Masahiko; Ryu, Morin; Himori, Noriko; Nitta, Fumihiko; Omodaka, Kazuko; Doi, Hiroshi; Yasui, Tomoki; Fuse, Nobuo; Nishida, Kohji

doi:10.1097/ijg.0b013e3182182897

Cited by 35 publications

(22 citation statements)

References 8 publications

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“…Furthermore, reliable methods for disc classification are also important, because of differing clinical characteristics in patients with each disc type (i.e., Nicolela’s 4 types) and the impact on the pattern of progress. [22, 30] However, classification of the ONH according to Nicolela’s methods is affected by variations arising from the subjectivity of judgments made based on funduscopic observations. [21] Thus, an objective, highly reproducible method for disc classification is an important goal for improving individual treatment of glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…[20] Follow-up investigations determined clinical characteristics associated with ONH morphological type in OAG patients, including the progression of visual field loss, differences in the structure/function relationship, the susceptibility to change in cpRNFLT, and various depth in anterior surface of lamina cribrosa. [22–26] Thus, the importance of optic disc morphological characteristics lies in their relationship with clinical characteristics. However, assessment of the optic disc can sometimes be difficult because of the subjectivity of current examination techniques and variability between individuals.…”

Section: Introductionmentioning

confidence: 99%

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OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

et al. 2016

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PurposeTo objectively classify the optic discs of open-angle glaucoma (OAG) patients into Nicolela's four disc types, i.e., focal ischemic (FI), myopic (MY), senile sclerotic (SS), and generalized enlargement (GE), with swept-source optical coherence tomography (SS-OCT).MethodsThis study enrolled 113 eyes of 113 OAG patients (mean age: 62.5 ± 12.6; Humphrey field analyzer-measured mean deviation: -9.4 ± 7.3 dB). Newly developed software was used to quantify a total of 20 optic disc parameters in SS-OCT (DRI OCT-1, TOPCON) images of the optic disc. The most suitable reference plane (RP) above the plane of Bruch’s membrane opening was determined by comparing, at various RP heights, the SS-OCT-measured rim parameters and spectral-domain OCT-measured circumpapillary retinal nerve fiber layer thickness (cpRNFLT), with Pearson's correlation analysis. To obtain a discriminant formula for disc type classification, a training group of 72 eyes of 72 OAG patients and a validation group of 60 eyes of 60 OAG patients were set up.ResultsCorrelation with cpRNFLT differed with disc type and RP height, but overall, a height of 120 μm minimized the influence of disc type. Six parameters were most significant for disc type discrimination: disc angle (horizontal), average cup depth, cup/disc ratio, rim-decentering ratio, average rim/disc ratio (upper and lower nasal). Classifying the validation group with these parameters returned an identification rate of 80.0% and a Cohen’s Kappa of 0.73.ConclusionOur new, objective SS-OCT-based method enabled us to classify glaucomatous optic discs with high reproducibility and accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

et al. 2016

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“…Occurrences of rim notch, thinning of the local rim and enlargement of the ONH cup are especially important signs of risk [9]. In a previous study of glaucomatous ONH types using Nicolela's classification method, we found that the progression speed of glaucomatous visual field defects differed with ONH types [10]. Identifying certain patterns of glaucomatous ONH morphology may improve diagnostic accuracy and aid in identifying the effects of structural changes on visual function [11], [12].…”

Section: Introductionmentioning

confidence: 88%

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

et al. 2014

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PurposeThe Glaucoma Stereo Analysis Study (GSAS), a cross sectional multicenter collaborative study, used a stereo fundus camera to assess various morphological parameters of the optic nerve head (ONH) in glaucoma patients and investigated the relationships between these parameters and patient characteristics.Subjects and MethodsThe study included 187 eyes of 187 subjects with primary open angle glaucoma or normal tension glaucoma (male: female = 100: 87, age = 61±9 years). Stereo pairs of ONH photographs were made with a stereo fundus camera (nonmyd WX). ONH morphological parameters were calculated with prototype analysis software. In addition to 35 standard parameters, we defined three novel parameters: disc tilt angle, rim decentering, and the absolute value of rim decentering. The correlation between each parameter and patient characteristics was analyzed with Spearman's rank correlation coefficient.ResultsPatient characteristics included refractive error of −3.38±3.75 diopters, intraocular pressure (IOP) of 13.6±2.6 mmHg, and visual field mean deviation (MD) of −4.71±3.26 dB. Representative ONH parameters included a horizontal disc width of 1.66±0.28 mm, vertical disc width of 1.86±0.23 mm, disc area of 2.42±0.63 mm2, cup area of 1.45±0.57 mm2, and cup volume of 0.31±0.22 mm3. Correlation analysis revealed significant negative associations between vertical cup-to-disc ratio (0.82±0.08) and MD (r = −0.40, P<0.01) and between disc tilt angle (10.5±12.5 degrees) and refractive error (r = −0.36, P<0.01). Seventy-five percent of the eyes had a positive value for rim decentering (0.30±0.42), indicating that rim thinning manifested more often as an inferior lesion than a superior lesion.ConclusionWe used stereoscopic analysis to establish a database of ONH parameters, which may facilitate future studies of glaucomatous changes in ONH morphology.

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“…Furthermore, macular lesions are often present in NTG. As we have previously demonstrated, the myopic disc type is more common in patients with NTG 11,12 and glaucoma patients with decreased visual acuity, 13 when patients are classified by optic disc type according to Nicolela's method. 14,15 In Japan, there is a high prevalence of myopia, which is associated with a high prevalence of myopia in NTG patients.…”

Section: Introductionmentioning

confidence: 78%

Topographical Correlation Between Macular Layer Thickness and Clockwise Circumpapillary Retinal Nerve Fiber Layer Sectors in Patients with Normal Tension Glaucoma

Omodaka¹,

Yokoyama²,

Shiga³

et al. 2014

Current Eye Research

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Progression of Visual Field Defects in Eyes With Different Optic Disc Appearances in Patients With Normal Tension Glaucoma

Abstract: The rate of progression of the field defects, the MD slope, in patients with NTG is possibly dependent on the baseline optic disc appearance. Thus, the optic disc appearance may be useful for the management of patients with NTG.

Cited by 35 publications

References 8 publications

OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

OCT-Based Quantification and Classification of Optic Disc Structure in Glaucoma Patients

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

Topographical Correlation Between Macular Layer Thickness and Clockwise Circumpapillary Retinal Nerve Fiber Layer Sectors in Patients with Normal Tension Glaucoma

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