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  • Frequency of abnormal retinal nerve fibre layer and ganglion cell layer SDOCT scans in healthy eyes and glaucoma suspects in a prospective longitudinal study

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Clinical science
Frequency of abnormal retinal nerve fibre layer and ganglion cell layer SDOCT scans in healthy eyes and glaucoma suspects in a prospective longitudinal study
  1. Shawn M Iverson1,
  2. William J Feuer1,
  3. Wei Shi1,
  4. David S Greenfield1,
  5. Advanced Imaging for Glaucoma Study Group1–4
  1. 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida, USA
  2. 2Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
  3. 3UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  4. 4Department of Ophthalmology, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  1. Correspondence to Dr David S Greenfield, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 7101 Fairway Drive, Palm Beach Gardens, FL 33418, USA; dgreenfield{at}med.miami.edu

Abstract

Background/aims To examine the frequency of abnormal retinal nerve fibre layer thickness (RNFLT) and ganglion cell complex (GCC) measurements among healthy and glaucoma suspect and preperimetric glaucoma (GSPPG) eyes in a prospective longitudinal study.

Methods Normal and GSPPG eyes with ≥18 months follow-up were included. Spectral-domain optical coherence tomography (SDOCT) was performed annually in normal and biannually in GSPPG eyes. One eye was randomly selected for inclusion. RNFLT and GCC parameters with p>5% were classified as ‘within normal limits (WNL)’ and p<1% were classified as ‘outside normal limits (ONL)’.

Results 23 normal and 74 GSPPG eyes were followed for a mean 43.4±9.6 months. During serial follow-up, 100% and 91% of normal eyes had all RNFLT and GCC parameters classified as WNL, respectively. 27 (37%) and 17 (23%) of GSPPG eyes had an ONL classification in at least one RNFLT and GCC parameter, respectively. A high percentage (41%–56%) of RNFLT and GCC measurements classified as ONL were not replicated on subsequent scans. The rates of loss for all parameters were similar (p>0.05) between the groups.

Conclusions Specificity in this sample of healthy eyes was very high for RNFLT and GCC parameters. Confirmation of suspected SDOCT abnormalities is recommended to differentiate reproducible loss from long-term variability.

http://dx.doi.org/10.1136/bjophthalmol-2013-303877

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