Optical coherence tomography longitudinal evaluation of retinal nerve fiber layer thickness in glaucoma

Arch Ophthalmol. 2005 Apr;123(4):464-70. doi: 10.1001/archopht.123.4.464.


Objectives: To longitudinally evaluate optical coherence tomography (OCT) peripapillary retinal nerve fiber layer thickness measurements and to compare these measurements across time with clinical status and automated perimetry.

Methods: Retrospective evaluation of 64 eyes (37 patients) of glaucoma suspects or patients with glaucoma participating in a prospective longitudinal study. All participants underwent comprehensive clinical assessment, visual field (VF) testing, and OCT every 6 months. Field progression was defined as a reproducible decline of at least 2 dB in VF mean deviation from baseline. Progression of OCT was defined as reproducible mean retinal nerve fiber layer thinning of at least 20 mum.

Results: Each patient had a median of 5 usable OCT scans at median follow-up of 4.7 years. The difference in the linear regression slopes of retinal nerve fiber layer thickness between glaucoma suspects and patients with glaucoma was nonsignificant for all variables; however, Kaplan-Meier survival curve analysis demonstrated a higher progression rate by OCT vs VF. Sixty-six percent of eyes were stable throughout follow-up, whereas 22% progressed by OCT alone, 9% by VF mean deviation alone, and 3% by VF and OCT.

Conclusions: A greater likelihood of glaucomatous progression was identified by OCT vs automated perimetry. This might reflect OCT hypersensitivity or true damage identified by OCT before detection by conventional methods.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Diagnostic Techniques, Ophthalmological*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glaucoma / diagnosis*
  • Glaucoma / physiopathology
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Ocular Hypertension / diagnosis
  • Ocular Hypertension / physiopathology
  • Optic Nerve Diseases / diagnosis*
  • Optic Nerve Diseases / physiopathology
  • Retinal Ganglion Cells / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*
  • Visual Field Tests
  • Visual Fields