Comparison of Event-Based Analysis Versus Trend-Based Analysis in the Detection of Glaucoma Progression by Optical Coherence Tomography 3-Dimensional Rim Measurements.

Journal: Journal Of Glaucoma
Published:
Abstract

Conclusions: Compared to trend-based analysis, event-based analysis detects OCT structural progression in more patients and at an earlier timepoint. Using event-based analysis, MDB rim thickness detects progression more often than RNFL thickness.

Objective: To determine if event-based or trend-based analysis best detects glaucoma progression using spectral domain optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and minimum distance band (MDB) neuroretinal rim measurements.

Methods: Over 5 years, 124 open-angle glaucoma patients had yearly dilated eye exams, disc photography, Humphrey visual field (HVF 24-2) testing, 2-dimensional (2D) OCT RNFL thickness measurements, and 3-dimensional (3D) OCT MDB rim measurements, all on the same day. One eye of each patient was analyzed, which was randomly selected if both eyes from a patient were eligible. Using global RNFL thickness and global MDB rim thickness, event-based progression was defined as change greater than normal aging change and expected inter-test variability. Trend-based analysis used linear regression with progression defined as rate of decline greater than age-related decline.

Results: Average follow-up for the 124 open-angle glaucoma patients was 66.9±16.4 months. Event-based analysis was better than trend-based analysis, because it detected progression in more patients (15.3% by RNFL event-based analysis versus 8.1% by RNFL trend-based analysis, P=0.025; 52.4% by MDB event-based analysis versus 9.7% by MDB trend-based analysis, P<0.001) and earlier (RNFL: mean 28.8 months vs. 63.2 months; P<0.001; MDB: mean 30.7 months vs. 56.2 months; P<0.003) whether using MDB rim thickness or RNFL thickness. Using event-based analysis, MDB rim thickness detected progression more often than RNFL thickness (52.4% vs. 15.3%; P<0.001).

Conclusions: Compared to trend-based analysis, event-based analysis detected OCT structural progression in more glaucoma patients and at an earlier timepoint.

Authors
Tamara Scott, Maria Guzman Aparicio, Kitiya Ratanawongphaibul, Hang Lee, Michele Zemplenyi, Edem Tsikata, Milica Margeta, Courtney Ondeck, Anne Coleman, Fei Yu, Johannes De Boer, Teresa Chen