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Evaluation of the long-term variability of macular OCT/OCTA and visual field parameters
  1. Jo-Hsuan Wu,
  2. Sasan Moghimi,
  3. Takashi Nishida,
  4. Evan Walker,
  5. Alireza Kamalipour,
  6. Elizabeth Li,
  7. Golnoush Mahmoudinezhad,
  8. Linda M Zangwill,
  9. Robert N Weinreb
  1. Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
  1. Correspondence to Dr Robert N Weinreb, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla 92093, California, USA; rweinreb{at}ucsd.edu

Abstract

Background/aims To assess the long-term variability of macular optical coherence tomography (OCT)/OCT angiography (OCTA) and visual field (VF) parameters.

Methods Healthy and glaucoma eyes with ≥1-year follow-up were included. 24–2 VF and macular OCT/OCTA parameters, including VF mean deviation (MD), whole-image vessel density (wiVD) and ganglion cell complex thickness (wiGCC) were analysed. Intraclass correlation coefficient (ICC), root mean squared error (RMSE), within-subject test–retest SD (Sw) and test–retest variability were calculated for stable eye cohort (max follow-up=1.5 years). Rates of change and RMSE were evaluated in the extended cohort including all eyes (unlimited follow-up).

Results From a total of 230 eyes (150 participants; age=67.7 years), 86 eyes (37%, 62 participants) were stable. In stable eyes, OCT parameters showed the highest mean (95%) ICC (wiGCC=0.99 (0.99, 0.99)), followed by VF (VF MD=0.91 (0.88, 0.93)) and OCTA (wiVD=0.82 (0.75, 0.87)). RMSE and Sw for VF MD were 0.92 dB and 0.81 dB, respectively, for wiVD were 1.64% and 1.48%, respectively, and for wiGCC, 0.91 µm and 0.78 µm, respectively. The long-term test–rest variability of VF MD, wiVD and wiGCC was 2.2 dB, 4.1% and 2.2 µm, respectively. In the extended cohort (mean follow-up=3.0 years), all parameters had significant rates of change (p<0.001), and compared with the stable cohort, only slightly higher RMSE (VF MD=1.07 dB; wiGCC=2.03 µm; wiVD=2.57%) were found.

Conclusions VF and macular OCT/OCTA, particularly OCT parameters, showed small long-term variability in all eyes, including stable ones, supporting the use of these instruments in glaucoma follow-up. Changes in macular VD and GCC greater than 4%–5% and 2 µm, respectively, indicate possible progression.

Trial registration number NCT00221897.

  • Glaucoma

Data availability statement

Data are available on reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Data availability statement

Data are available on reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Footnotes

  • J-HW and SM contributed equally.

  • Contributors Concept and design: J-HW, SM and TN; Acquisition and reviewing of data: J-HW, SM, TN, EW, EL, GM, AK and LMZ; Analysis or interpretation of data: J-HW, SM, TN, EW, LMZ and RNW; Drafting of the manuscript: J-HW and SM; Obtained funding: SM, LMZ and RNW; Supervision: SM and RNW. Guarantor: RNW.

  • Funding This work is supported by National Institutes of Health/National Eye Institute Grants (R01EY029058, R01EY011008, R01EY019869, R01EY027510, R01EY026574, R01EY018926 P30EY022589); University of California Tobacco Related Disease Research Program (T31IP1511), and an unrestricted grant from Research to Prevent Blindness (New York, New York, USA).

  • Disclaimer The sponsor or funding organisation had no role in the design or conduct of this research.

  • Competing interests Acknowledgements/Financial Disclosures. Commercial Disclosures: LMZ reported grants from the National Eye Institute and Heidelberg Engineering; non-financial support from Carl Zeiss Meditec, Optovue, Heidelberg Engineering and Topcon; consultant of Abbvie and patents from Carl Zeiss Meditec. RNW is a consultant of Abbvie, Aerie Pharmaceuticals, Allergan, Amydis, Equinox, Eyenovia, Iantrek, IOPtic, Implandata, Nicox, and Topcon. RNW reported nonfinancial support from Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Centervue and Topcon; grants from the National Eye Institute; patents from Toromedes, Carl Zeiss Meditec; all outside the submitted work. No other disclosures were reported. Other acknowledgements: None.b. Grant information/Funding/Support: This work is supported by National Institutes of Health/National Eye Institute Grants R01EY029058, R01EY011008, R01EY019869, R01EY027510, R01EY026574, R01EY018926, P30EY022589; University of California Tobacco Related Disease Research Program (T31IP1511); and an Unrestricted Grant from Research to Prevent Blindness (New York, New York, USA).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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