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

Abstract

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.

Porównanie czułości metod BMO-MRW, GCC, ONH i RNFL w diagnostyce i ocenie leczenia jaskry młodzieńczej

“…These publications concerned other forms of glaucoma (open-angle glaucoma in adults), but their results probably also apply to juvenile glaucoma. Studies by many authors have shown that changes in BMO-MRW occur earlier than changes in RNFL in patients with open-angle glaucoma [6,8,[10][11][12][13]. In other clinical studies, it has been found that the results of the assessment of the thickness of the layer of retinal nerve fibers with BMO-MRW and RNFL are comparable in patients with glaucoma [7,15,16] and in healthy subjects [17].…”

“…Measurements are made in radial scans of various meridians of the optic nerve disc. Clinical studies have shown that BMO-MRW is an objective and valuable diagnostic tool for assessing the degree of damage to the nerve fibers of the retina on the optic nerve disc [5][6][7][8][9][10][11][12][13][14][15][16][17]. Many studies have found that BMO-MRW is a more sensitive and specific parameter of the glaucomatous damage to the optic disc than the visual field, ONH and RNFL [5][6][7][8][9][10][11][12][13][14][15][16][17].…”

“…Clinical studies have shown that BMO-MRW is an objective and valuable diagnostic tool for assessing the degree of damage to the nerve fibers of the retina on the optic nerve disc [5][6][7][8][9][10][11][12][13][14][15][16][17]. Many studies have found that BMO-MRW is a more sensitive and specific parameter of the glaucomatous damage to the optic disc than the visual field, ONH and RNFL [5][6][7][8][9][10][11][12][13][14][15][16][17]. The aim of this paper is to compare the sensitivity of the BMO-MRW method with other methods used for the assessment of damage to retinal nerve fibers in patients with juvenile glaucoma.…”

Comparison of Retinal Nerve Fiber Layer Thickness and Bruch’s Membrane Opening Minimum Rim Width Thinning Rate in Open-Angle Glaucoma

“…Previous studies have compared the rate of thinning between RNFLT and BMO-MRW with serial OCT examinations [6,10]. Cho and Kee [6] compared the progression rates of RNFLT and BMO-MRW in eyes with disc hemorrhage.…”

New views on three-dimensional imaging technologies for glaucoma: an overview

“…The earliest commercially available reference plane-independent parameter is the low-density Bruch's membrane opening-minimum rim width (BMO-MRW) parameter, which quantifies 360° of rim tissue in 3D space using the cup surface as the inner rim border and the BMO disc border as the outer rim border. Articles suggest that the BMO-MRW is the same as or better than both RNFL thickness and reference plane-dependent rim area for diagnosing glaucoma and monitoring disease progression [ 32 , 33 , 34 ▪▪ ].…”