Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

Association between Intraocular Pressure and Rates of Retinal Nerve Fiber Layer Loss Measured by Optical Coherence Tomography

Author Diniz-Filho, Alberto Google Scholar
Abe, Ricardo Y. Google Scholar
Zangwill, Linda M. Google Scholar
Gracitelli, Carolina Pelegrini Barbosa Autor UNIFESP Google Scholar
Weinreb, Robert N. Google Scholar
Girkin, Christopher A. Google Scholar
Liebmann, Jeffrey M. Google Scholar
Medeiros, Felipe A. Google Scholar
Abstract Purpose: To evaluate the relationship between intraocular pressure (IOP) and rates of retinal nerve fiber layer (RNFL) thickness change over time measured by spectral-domain (SD) optical coherence tomography (OCT). Design: Observational cohort study. Participants: The study involved 547 eyes of 339 patients followed up for an average of 3.9 +/- 0.9 years. Three hundred eight (56.3%) had a diagnosis of glaucoma and 239 (43.7%) were considered glaucoma suspects. Methods: All eyes underwent imaging using the Spectralis SD OCT (Heidelberg Engineering GmbH, Heidelberg, Germany), along with IOP measurements and standard automated perimetry (SAP). Glaucoma progression was defined as a result of "Likely Progression" from the Guided Progression Analysis software for SAP. Linear mixed models were used to investigate the relationship between average IOP during follow-up and rates of RNFL thickness change, while taking into account potential confounding factors such as age, race, corneal thickness, and baseline disease severity. Main Outcome Measures: The association between IOP and rates of global and sectorial RNFL thickness loss measured by SD OCT. Results: Forty-six eyes (8.4%) showed progression on SAP during follow-up. Rates of global RNFL thickness change in eyes that progressed by SAP were faster than in those that did not progress (-1.02 vs. -0.61 mu m/year, respectively

P = 0.002). For progressing eyes, each 1-mmHg higher average in IOP during follow-up was associated with an additional average loss of 0.20 mu m/year (95% confidence interval [CI]: 0.08 to 0.31 mm/year

P < 0.001) of global RNFL thickness versus only 0.04 mu m/year (95% CI: 0.01 to 0.07 mu m/year

P = 0.015) for nonprogressing eyes. The largest associations between IOP and rates of RNFL change were seen for measurements from the temporal superior and temporal inferior sectors, whereas the smallest association was seen for measurements from the nasal sector. Conclusions: Higher levels of IOP during follow-up were associated with faster rates of RNFL loss over time measured by SD OCT. These findings support the use of SD OCT RNFL thickness measurements as biomarkers for the evaluation of the efficacy of IOP-lowering therapies to slow down the rate of disease progression. (C) 2016 by the American Academy of Ophthalmology.
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Sponsor National Eye Institute (NEI) National Institutes of Health (NIH) Health and Human Services (HHS)
Grant number NEI NIH HHS: P30 EY022589
NEI NIH HHS: R01 EY021818
Date 2016
Published in Ophthalmology. New York, v. 123, n. 10, p. 2058-2065, 2016.
ISSN 0161-6420 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent 2058-2065
Origin http://dx.doi.org/10.1016/j.ophtha.2016.07.006
Access rights Closed access
Type Article
Web of Science ID WOS:000389509100004
URI https://repositorio.unifesp.br/handle/11600/56959

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