1
|
von Arenstorff MM, Ahmadzadeh A, Schmidt BS, Kessel L, Bach-Holm D. Vision-related quality of life in patients with glaucoma before and after trabeculectomy. Acta Ophthalmol 2024. [PMID: 38655879 DOI: 10.1111/aos.16697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To determine vision-related quality of life (VR-QoL) and functional and structural parameters associated with VR-QoL in patients with glaucoma before and 12 months after trabeculectomy. METHODS Fifty-eight patients undergoing trabeculectomy were included. Participants completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) prior to and 12 months after trabeculectomy. Functional (visual acuity and visual fields) and structural (ganglion cell layer volume) parameters were evaluated for their association with VR-QoL using multiple linear regression of VFQ-25 subscale scores. Intraocular pressure and the number of glaucoma medications were also included in the analyses. RESULTS The VFQ-25 composite score did not change after trabeculectomy (before: 74.9; 12 months: 74.0; p = 0.512). The subscale mental health had a significantly higher score 12 months after trabeculectomy (before: 65.6; 12 months: 71.4; p = 0.017). The VFQ-25 scores for general health (before: 68.5; 12 months: 62.5; p = 0.009) and role difficulties (before: 78.9; 12 months: 53.7; p < 0.001) were significantly lower 12 months after trabeculectomy. No functional or structural parameters were associated with VFQ-25 composite score. CONCLUSION Overall, VR-QoL in glaucoma patients was similar before and after trabeculectomy, reflecting the procedure's stabilizing effect on both objective and subjective visual function. The absence of correlations between VR-QoL and clinical parameters emphasizes the multifaceted nature of VR-QoL and highlights the limitations of depending solely on objective clinical metrics to evaluate patients' subjective experiences. Using both objective measures and VR-QoL, clinicians can better understand the challenges patients face due to glaucoma and trabeculectomy, potentially leading to better solutions.
Collapse
Affiliation(s)
- Mathilde M von Arenstorff
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
| | - Afrouz Ahmadzadeh
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
| | | | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniella Bach-Holm
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Santos MAK, Vonor K, Maneh N, Kuaovi KR, Ayena KD. [Clinical profile of patients with perimetric glaucomatous macular damage in Lomé]. J Fr Ophtalmol 2024; 47:103970. [PMID: 37884422 DOI: 10.1016/j.jfo.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/21/2023] [Accepted: 07/17/2023] [Indexed: 10/28/2023]
Affiliation(s)
- M A K Santos
- Département d'ophtalmologie de l'université de Lomé, Lomé, Togo.
| | - K Vonor
- Département d'ophtalmologie de l'université de Kara, Kara, Togo
| | - N Maneh
- Département d'ophtalmologie de l'université de Lomé, Lomé, Togo
| | - K R Kuaovi
- Clinique ophtalmologique AFIA, Lomé, Togo
| | - K D Ayena
- Département d'ophtalmologie de l'université de Lomé, Lomé, Togo
| |
Collapse
|
3
|
Lee A, Kim KE, Song WK, Yoon J, Kook MS. Progressive Macular Vessel Density Loss and Visual Field Progression in Open-angle Glaucoma Eyes with Central Visual Field Damage. Ophthalmol Glaucoma 2024; 7:16-29. [PMID: 37379886 DOI: 10.1016/j.ogla.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE To investigate the association between the longitudinal changes in both macular vessel density (mVD) and macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and visual field (VF) progression (including central VF progression) in open-angle glaucoma (OAG) patients with central visual field (CVF) damage at different glaucoma stages. DESIGN Retrospective longitudinal study. PARTICIPANTS This study enrolled 223 OAG eyes with CVF loss at baseline classified as early-to-moderate (133 eyes) or advanced (90 eyes) stage based on the VF mean deviation (MD) (-10 dB). METHODS Serial mVDs at parafoveal and perifoveal sectors and mGCIPLT measurements were obtained using OCT angiography and OCT during a mean follow-up of 3.5 years. Visual field progression was determined using both the event- and trend-based analyses during follow-up. MAIN OUTCOME MEASURES Linear mixed-effects models were used to compare the rates of change in each parameter between VF progressors and nonprogressors. Logistic regression analyses were performed to determine the risk factors for VF progression. RESULTS In early-to-moderate stage, progressors showed significantly faster rates of change in the mGCIPLT (-1.02 vs. -0.47 μm/year), parafoveal (-1.12 vs. -0.40%/year), and perifoveal mVDs (-0.83 vs. -0.44%/year) than nonprogressors (all P < 0.05). In advanced stage cases, only the rates of change in mVDs (parafoveal: -1.47 vs. -0.44%/year; perifoveal: -1.04 vs. -0.27%/year; all P < 0.05) showed significant differences between the groups. By multivariable logistic regression analyses, the faster rate of mVD loss was a predictor of VF progression regardless of glaucoma stage, while the rate of mGCIPLT loss was significantly associated with VF progression only in early-to-moderate stage cases. CONCLUSIONS Progressive mVD loss is significantly associated with VF progression (including central VF progression) in the OAG eyes with CVF loss regardless of the glaucoma stage. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Anna Lee
- Department of Ophthalmology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Ko Eun Kim
- Department of Ophthalmology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Woo Keun Song
- Department of Ophthalmology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Jooyoung Yoon
- Department of Ophthalmology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Michael S Kook
- Department of Ophthalmology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea.
| |
Collapse
|
4
|
Latif K, Nishida T, Moghimi S, Weinreb RN. Quality of life in glaucoma. Graefes Arch Clin Exp Ophthalmol 2023; 261:3023-3030. [PMID: 37017741 DOI: 10.1007/s00417-023-06050-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/07/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND An essential goal of glaucoma management is to prevent a patient's visual impairment that compromises their health-related quality of life (QOL). The disease itself, in addition to the medical or surgical treatment, can have a large impact on one's life. We aim to briefly review and evaluate aspects of QOL in glaucoma. METHODS The PubMed database was utilized for the literature examination of this review. Keywords that were searched included glaucoma, quality of life, vision-related QOL (VRQOL), quality of life questionnaire, and glaucoma therapy. RESULTS The main topics identified and analyzed during the literature review stages include factors affecting VRQOL, the assessment of VRQOL using questionnaires, QOL in early and severe glaucoma, glaucoma and activities of daily living, glaucoma treatments, and new advances in clinically assessing QOL. The study findings indicate a relationship between the deterioration of visual field and the quality of life. The investigation shows that visual loss can result in a range of daily life challenges, which include compromised mental health status and difficulties with driving, reading, and recognizing people. CONCLUSION Glaucoma-induced visual field loss can significantly impact different aspects of patients' life, and several methods exist for evaluating changes in quality of life. Quality of life assessments have their limitations as they are subjective. As potential future steps, we suggest exploring technological advancements such as virtual reality to improve patient care and outcomes.
Collapse
Affiliation(s)
- Kareem Latif
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA.
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
| |
Collapse
|
5
|
Liu WW, Shalaby WS, Shiuey EJ, Raghu R, Petkovsek D, Myers JS, Wizov SS, Spaeth GL, Shukla AG. Correlation between Central Visual Field Defects and Stereopsis in Patients with Early-to-Moderate Visual Field Loss. Ophthalmol Glaucoma 2023; 6:493-500. [PMID: 37080537 PMCID: PMC10664360 DOI: 10.1016/j.ogla.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE To investigate the association between stereoacuity and the presence of central visual field defects (CVFDs) due to glaucoma. DESIGN A prospective, cross-sectional cohort study. PARTICIPANTS Participants with early-to-moderate glaucoma with a visual acuity better than 20/40, less than a 2-line difference in visual acuity between eyes, and 2 reliable Humphrey visual fields (VFs) (24-2 SITA standard) with mean deviation (MD) in the worse eye better than - 12 dB. METHODS Stereoacuity was measured using the Titmus stereo test. Participants with a significant field defect (P < 0.005) in any 1 of the central 4 points in the 24-2 SITA standard total deviation map in either eye were classified as having a CVFD. Vision-related quality of life (VR-QOL) was measured using 25-item National Eye Institute Visual Function Questionnaire scores. Logistic regression was used to determine the associations between the level of stereoacuity and age, sex, race, glaucoma type, presence of CVFDs, visual acuity, contrast sensitivity, and VF MD. MAIN OUTCOME MEASURES Stereoacuity in the CVFD and non-CVFD groups. RESULTS Sixty-five participants met the inclusion criteria. The mean age of the participants was 64.3 ± 8.0 years, and 64.6% were women. The median stereoacuity was 60 arc seconds (interquartile range [IQR], 40-120 arc seconds). Forty-two (65%) patients had CVFDs, and 23 (35%) patients did not. The median stereoacuity of the CVFD group was worse than that of the non-CVFD group (60 arc seconds [IQR, 50-140 arc seconds] vs. 40 arc seconds [IQR, 40-80 arc seconds], respectively; P = 0.001). The non-CVFD group had a higher percentage of participants with normal stereopsis than the non-CVFD group (61% vs. 21%, respectively; P = 0.001). A multivariable analysis found that the presence of CVFDs was associated with worse stereopsis levels (odds ratio, 4.49; P = 0.021). The CVFD group had a lower Visual Functioning Questionnaire-25 (VFQ-25) composite score (84.0 vs. 91.4; P = 0.004) and lower VFQ-25 subscale scores for general vision, near activities, and mental health (P < 0.05). CONCLUSIONS Central visual field defects were associated with increased odds of poor stereoacuity in patients with early-to-moderate glaucomatous VF loss. Specifically, patients without CVFDs are more likely to have normal stereopsis and higher VR-QOL than those with CVFDs. Patients with CVFDs should be counseled regarding how depth perception difficulties may affect daily living. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Wendy W Liu
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California; Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania.
| | - Wesam S Shalaby
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt
| | - Eric J Shiuey
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rahul Raghu
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Daniel Petkovsek
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Jonathan S Myers
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Sheryl S Wizov
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - George L Spaeth
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Aakriti Garg Shukla
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania; Columbia University Irving Medical Center, New York, New York.
| |
Collapse
|
6
|
Jackson AB, Martin KR, Coote MA, Medeiros FA, Girkin CA, Fazio MA, Liebmann JM, De Moraes CG, Weinreb RN, Zangwill LM, Wu Z. Fast Progressors in Glaucoma: Prevalence Based on Global and Central Visual Field Loss. Ophthalmology 2023; 130:462-468. [PMID: 36693593 PMCID: PMC10121866 DOI: 10.1016/j.ophtha.2023.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/04/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To determine the prevalence of fast global and central visual field (VF) progression in individuals with glaucoma under routine care. DESIGN Observational study. PARTICIPANTS Six hundred ninety-three eyes of 461 individuals with glaucoma followed up over a median of 4.5 years. METHODS This study included (1) patients at a private ophthalmology clinic in Melbourne, Australia, and (2) individuals in 2 prospective longitudinal observational studies across 3 sites in the United States. All individuals had a diagnosis of glaucoma and were under routine care, and had performed 5 or more reliable 24-2 VF tests over a 1- to 5-year period. Ordinary least squares regression analyses were used to calculate the rate of global mean deviation (MD) change over time and the rate of the mean total deviation values of the 12 test locations within the central 10° region (MTD10) for each eye. MAIN OUTCOME MEASURES Prevalence of progression based on the rate of MD and the MTD10 change across various fixed cutoffs and cutoffs based on the estimated normal distribution (from the positive slopes). RESULTS Based on the MD and the MTD10, 12.5% and 11.7% of the eyes, respectively, exhibited a rate of change that was less than -1.0 dB/year (being a rate that typically is defined as "fast progression" for MD values), and 29.0% of the eyes showed a change of less than -0.5 dB/year on MTD10. Furthermore, 12.7% and 9.1% of the eyes exhibited a rate of change that exceeded the 1% cutoff of the estimated normal distribution MD and the MTD10 values, respectively. CONCLUSIONS This study found that approximately 1 in 8 eyes with glaucoma receiving routine care showed fast progression based on global MD values (< -1.0 dB/year) and that nearly 1 in 3 eyes showed a < -0.5 dB/year decline centrally. These findings highlight the clinical importance of assessing progressive central VF loss and reinforce the need for new therapies to prevent functional disability in a notable proportion of individuals who continue to exhibit fast progression. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Aidan B Jackson
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Keith R Martin
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia; John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom
| | - Michael A Coote
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Felipe A Medeiros
- Duke Eye Center and Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Christopher A Girkin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Massimo A Fazio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Carlos Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Zhichao Wu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
7
|
Bonham LW, Mihailovic A, Xiao G, West SK, Friedman DS, Ramulu PY. Association of Optic Nerve Head and Macular Optical Coherence Tomography Measures With Glaucoma-Related Disability. J Glaucoma 2023; 32:340-346. [PMID: 37079508 PMCID: PMC10133014 DOI: 10.1097/ijg.0000000000002191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/21/2023] [Indexed: 04/21/2023]
Abstract
PRCIS Optical coherence tomography (OCT) estimated retinal nerve fiber layer (RNFL) thickness associated with glaucoma-related disability independent of the visual field (VF) damage and thus may provide additional patient-relevant disability information beyond what is captured by standard VF testing. PURPOSE To examine whether OCT metrics [peripapillary RNFL thickness and macular ganglion cell/inner plexiform layer (GCIPL) thickness] are associated with quality of life (QoL) measures and additional disability metrics, and whether these associations are independent of VF damage. METHODS In this cross-sectional study, 156 patients with glaucoma or suspected glaucoma received VF testing and OCT scans to measure RNFL and GCIPL thickness. QoL was assessed using the Glaucoma Quality-of-Life 15 and additional disability measures including fear of falling, reading speed, and steps per day were assessed. Multivariable regression models adjusting for relevant covariates tested whether RNFL or GCIPL thickness from the less-impaired eye were associated with disability measures and whether associations were independent of VF damage. RESULTS Greater VF damage is associated with worse QoL (95% CI=0.4-1.4; P <0.001) and slower reading speed (CI=-0.06 to -0.02; P <0.001). Lower RNFL and GCIPL thicknesses were associated with lower QoL scores, but not with QoL scores or other disability metrics after correcting for VF damage. However, post hoc analyses in patients with better eye thicknesses between 55 and 75 µm demonstrated associations between lower RNFL thickness and worse QoL (CI=-2.2 to -0.1; P =0.04) and greater fear of falling (CI=-6.1 to -0.4; P =0.03) even after accounting for VF damage. No such associations were observed for GCIPL thickness. CONCLUSIONS OCT RNFL, but not GCIPL, thickness is associated with multiple disability measures independent of VF damage severity.
Collapse
Affiliation(s)
- Luke W Bonham
- Wilmer Eye Institute
- Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Aleksandra Mihailovic
- Wilmer Eye Institute
- Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Grace Xiao
- Wilmer Eye Institute
- Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sheila K West
- Wilmer Eye Institute
- Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - David S Friedman
- Wilmer Eye Institute
- Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Pradeep Y Ramulu
- Wilmer Eye Institute
- Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
8
|
Nishida T, Moghimi S, Mohammadzadeh V, Wu JH, Yamane MLM, Kamalipour A, Mahmoudinezhad G, Micheletti E, Liebmann JM, Fazio MA, Girkin CA, Zangwill LM, Weinreb RN. Association Between Ganglion Cell Complex Thinning and Vision-Related Quality of Life in Glaucoma. JAMA Ophthalmol 2022; 140:800-806. [PMID: 35771529 DOI: 10.1001/jamaophthalmol.2022.2140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Faster structural changes may be associated with worse vision-related quality of life in patients with glaucoma. Objectives To evaluate the association between the rate of ganglion cell complex thinning and the Vision Function Questionnaire in glaucoma. Design, Setting, and Participants This retrospective analysis of a longitudinal cohort was designed in October 2021. Patients were enrolled from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Two hundred thirty-six eyes of 118 patients with diagnosed or suspected glaucoma were followed up with imaging for a mean of 4.1 years from September 2014 to March 2020. Main Outcomes and Measures The Vision Function Questionnaire was evaluated using the 25-item National Eye Institute Visual Function at the last follow-up visit. Ganglion cell complex thickness was derived from macular optical coherence tomography scans and averaged within 3 circular areas (3.4°, 5.6°, and 6.8° from the fovea) and superior and inferior hemiregions. Linear mixed-effects models were used to investigate the association between the rate of ganglion cell complex thinning and Rasch-calibrated Vision Function Questionnaire score. Results The mean (SD) age was 73.2 (8.7) years, 65 participants (55.1%) were female, and 53 participants (44.9%) were African American. Race was self-reported by the participants. Mean composite Rasch-calibrated National Eye Institute Visual Function Questionnaire score was 50.3 (95% CI, 45.9-54.6). A faster annual rate of global ganglion cell complex thinning in the better eye was associated with a higher disability reflected by the composite National Eye Institute Visual Function Questionnaire score (-15.0 [95% CI, -28.4 to -1.7] per 1 μm faster; P = .03). When stratified by degrees from the fovea, the 5.6° and 6.8° areas were associated with the composite National Eye Institute Visual Function Questionnaire Rasch-calibrated score (-14.5 [95% CI, -27.0 to -2.0] per 1 μm faster; R2 = 0.201; P = .03; and -23.7 [95% CI, -45.5 to -1.9] per 1 μm faster; R2 = 0.196; P = .02, respectively), and -8.0 (95% CI, -16.8 to 0.8) per 1 μm faster for the 3.4° area (R2 = 0.184; P = .07) after adjusting for confounding factors. Conclusions and Relevance These findings suggest that faster and sectoral central location of ganglion cell complex thinning provides useful information in determining the risk of vision-related quality of life in glaucoma. Monitoring macular structure may be useful for determining the risk of functional impairment in glaucoma.
Collapse
Affiliation(s)
- Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Maya L M Yamane
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York
| | - Massimo A Fazio
- Bernard School of Medicine, University of Alabama-Birmingham, Birmingham
| | | | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla
| |
Collapse
|
9
|
Detecting glaucoma with only OCT: Implications for the clinic, research, screening, and AI development. Prog Retin Eye Res 2022; 90:101052. [PMID: 35216894 DOI: 10.1016/j.preteyeres.2022.101052] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/21/2022] [Accepted: 02/01/2022] [Indexed: 12/25/2022]
Abstract
A method for detecting glaucoma based only on optical coherence tomography (OCT) is of potential value for routine clinical decisions, for inclusion criteria for research studies and trials, for large-scale clinical screening, as well as for the development of artificial intelligence (AI) decision models. Recent work suggests that the OCT probability (p-) maps, also known as deviation maps, can play a key role in an OCT-based method. However, artifacts seen on the p-maps of healthy control eyes can resemble patterns of damage due to glaucoma. We document in section 2 that these glaucoma-like artifacts are relatively common and are probably due to normal anatomical variations in healthy eyes. We also introduce a simple anatomical artifact model based upon known anatomical variations to help distinguish these artifacts from actual glaucomatous damage. In section 3, we apply this model to an OCT-based method for detecting glaucoma that starts with an examination of the retinal nerve fiber layer (RNFL) p-map. While this method requires a judgment by the clinician, sections 4 and 5 describe automated methods that do not. In section 4, the simple model helps explain the relatively poor performance of commonly employed summary statistics, including circumpapillary RNFL thickness. In section 5, the model helps account for the success of an AI deep learning model, which in turn validates our focus on the RNFL p-map. Finally, in section 6 we consider the implications of OCT-based methods for the clinic, research, screening, and the development of AI models.
Collapse
|
10
|
Micheletti E, Moghimi S, El-Nimri N, Nishida T, Suh MH, Proudfoot JA, Kamalipour A, Zangwill LM, Weinreb RN. Relationship of macular ganglion cell complex thickness to choroidal microvasculature drop-out in primary open-angle glaucoma. Br J Ophthalmol 2022; 107:809-815. [PMID: 35027356 DOI: 10.1136/bjophthalmol-2021-320621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIMS To investigate the rate of ganglion cell complex (GCC) thinning in primary open-angle glaucoma (POAG) patients with and without deep-layer microvasculature drop-out (MvD). METHODS POAG patients who had at least 1.5 years of follow-up and a minimum of three visits were included from the Diagnostic Innovations in Glaucoma Study. MvD was detected at baseline by optical coherence tomography angiography (OCT-A). Area and angular circumference of MvD were evaluated on en face choroidal vessel density images and horizontal B-scans. Rates of global and hemisphere GCC thinning were compared in MvD and non-MvD eyes using linear mixed-effects models. RESULTS Thirty-six eyes with MvD and 37 eyes without MvD of 63 patients were followed for a mean of 3.3 years. In 30 out of 36 eyes, MvD was localised in the inferotemporal region. While mean baseline visual field mean deviation was similar between the two groups (p=0.128), global GCC thinning was significantly faster in eyes with MvD than in those without MvD (mean differences: -0.50 (95% CI -0.83 to -0.17) µm/year; p=0.003)). Presence of MvD, area and angular circumference of MvD were independently associated with a faster rate of thinning (p=0.002, p=0.031 and p=0.013, respectively). CONCLUSION In POAG eyes, GCC thinning is faster in eyes with MvD. Detection of MvD in OCT-A images can assist clinicians to identify patients who are at higher risk for central macula thinning and glaucomatous progression and may require more intensive management.
Collapse
Affiliation(s)
- Eleonora Micheletti
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Nevin El-Nimri
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Min Hee Suh
- Ophthalmology, Inje University College of Medicine, Busan, Korea (the Republic of)
| | - James A Proudfoot
- Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, USA
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
11
|
Wen Y, Chen Z, Zuo C, Yang Y, Xu J, Kong Y, Cheng H, Yu M. Low-Contrast High-Pass Visual Acuity Might Help to Detect Glaucoma Damage: A Structure-Function Analysis. Front Med (Lausanne) 2021; 8:680823. [PMID: 34055847 PMCID: PMC8160221 DOI: 10.3389/fmed.2021.680823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/19/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: The conventional visual acuity (VA) test is not sensitive enough to detect glaucoma macular damage. We aimed to investigate whether VA measurements using low-contrast high-pass optotypes are more sensitive to macular dysfunction in glaucoma and to find the potential structural basis of this difference. Methods: A total of 147 subjects were recruited, including 118 patients with glaucoma (mean age: 46.08 ± 14.64 years) and 29 healthy controls (mean age: 39.83 ± 9.81 years). For each participant, monocular best-corrected VA was measured using a conventional chart and six high-pass charts at 100, 50, 10, 5, 2.5, and 1.25% contrast levels, respectively. The macular retinal thickness and circumpapillary retinal nerve fiber layer (cpRNFL) thickness of all the glaucoma patients were obtained by spectral-domain optical coherence tomography (SD-OCT). Results: Compared with healthy subjects, glaucoma patients with normal vision demonstrated worse VAs in high-pass acuity measurements (0.22–0.93 vs. 0.28–1.08, p < 0.05). Receiver operating characteristic curve (ROC) showed that 1.25% low-contrast high-pass VA was optimal for discriminating between the controls and glaucoma patients (AUC: 0.918, p < 0.001; sensitivity: 77.33%; specificity: 96.55%). Compared with conventional VA, 1.25% high-pass VA correlated better with nasal-side macular retinal ganglion cell (RGC)-related parameters (r = −0.419 to −0.446 vs. r = −0.538 to −0.582; Fisher's Z transformation, pz < 0.05). There was no difference in the strength of correlations between the VAs measured using different charts and cpRNFL thickness (Fisher's Z transformation; pz > 0.05). Conclusions: VA measurement taken with low-contrast (1.25%) high-pass acuity chart is more sensitive in detecting central visual loss in glaucoma than that taken with the conventional chart. Macular RGC damage appears to be associated with low-contrast (1.25%) high-pass visual loss in glaucomatous eyes.
Collapse
Affiliation(s)
- Yun Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zidong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Chengguo Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yangfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jiangang Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yang Kong
- School of Electronics and Communication Engineering, Sun Yat-sen University, Shenzhen, China
| | - Hui Cheng
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
12
|
Hirji SH, Hood DC, Liebmann JM, Blumberg DM. Association of Patterns of Glaucomatous Macular Damage With Contrast Sensitivity and Facial Recognition in Patients With Glaucoma. JAMA Ophthalmol 2021; 139:27-32. [PMID: 33151275 DOI: 10.1001/jamaophthalmol.2020.4749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Importance Facial recognition is a critical activity of daily living that relies on macular function. Glaucomatous macular damage may result in impaired facial recognition that may negatively affect patient quality of life. Objective To evaluate the association of patterns of glaucomatous macular damage with contrast sensitivity and facial recognition among patients with glaucoma. Design, Setting, and Participants In this prospective cohort study at a single tertiary care center, 144 eyes of 72 consecutive patients with glaucoma with good visual acuity (20/40 or better in each eye) were studied. Data were collected from March to April 2019. Exposures Eyes with macular damage were categorized as having focal, diffuse, or mixed (focal and diffuse) damage based on optic disc and macular spectral-domain optical coherence tomography and 10-2 visual field (VF) damage. Only eyes with focal or diffuse damage were included. Higher-acuity and lower-acuity eyes were determined by 10-2 VF mean deviation (MD). Facial disability was defined as facial recognition scores at the 2% level of normal participants. Main Outcomes and Measures (1) Monocular contrast threshold as measured by the Freiburg Visual Acuity and Contrast Test and (2) binocular facial recognition as measured by the Cambridge Face Memory Test. Results Of the 72 included patients, 49 (68%) were White and 41 (57%) were female, and the mean (SD) age was 67.0 (11.6) years. Eyes with diffuse damage had greater contrast impairment compared with eyes with focal damage (β = -0.5; 95% CI, -0.6 to -0.4; P < .001) after adjusting for 10-2 VF MD, 24-2 VF MD, age, presence of an early cataract, and number of drops. Similarly, Cambridge Face Memory Test scores were significantly lower in patients with diffuse rather than focal macular damage, regardless of eye (better-seeing eye: β = 10.0; 95% CI, 2.0 to 18.2; P = .001; worse-seeing eye: β = 5.5; 95% CI, 0.8 to 10.0; P = .23). Relative risk of facial disability was greater for patients with diffuse but not focal macular damage in the better-seeing eye (relative risk, 86.2; 95% CI, 2.7 to 2783.3; P = .01). Conclusions and Relevance In this cohort study, diffuse rather than focal glaucomatous macular damage was associated with diminished facial recognition and contrast sensitivity. Evaluation of macular optical coherence tomography and 10-2 VF and resultant detection of diffuse macular damage may help minimize glaucoma-related visual disability.
Collapse
Affiliation(s)
- Sitara H Hirji
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Donald C Hood
- Department of Psychology, Columbia University, New York, New York.,Department of Ophthalmology, Columbia University, New York, New York
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Dana M Blumberg
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
13
|
Khan SS, Hirji SH, Hood DC, Liebmann JM, Blumberg DM. Association of Macular Optical Coherence Tomography Measures and Deficits in Facial Recognition in Patients With Glaucoma. JAMA Ophthalmol 2021; 139:486-487. [PMID: 33704398 DOI: 10.1001/jamaophthalmol.2021.0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Sabine S Khan
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - Sitara H Hirji
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - Donald C Hood
- Department of Psychology, Columbia University, New York, New York.,Department of Ophthalmology, Columbia University, New York, New York
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| | - Dana M Blumberg
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
14
|
Khachatryan N, Pistilli M, Maguire MG, Chang AY, Samuels MR, Mulvihill K, Salowe RJ, O'Brien JM. A Review of Studies of the Association of Vision-Related Quality of Life with Measures of Visual Function and Structure in Patients with Glaucoma in the United States. Ophthalmic Epidemiol 2021; 28:265-276. [PMID: 33530788 DOI: 10.1080/09286586.2020.1863992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: To investigate the association of quality of life (QoL) with ocular structure and function in glaucoma patients, and to identify which aspects of QoL are most closely tied to Visual Field (VF) and Visual Acuity (VA).Methods: We conducted a comprehensive review of studies on QoL in glaucoma patients using PubMed, Web of Science, and Google Scholar (from 1 January 1997 to 7 December 2019). A total of 21 studies in the United States that used the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ) or 51-item NEI VFQ were included. A descriptive analysis of data from the selected studies was conducted. The association between QoL scores and visual function and structure was investigated by ranking the strength of association on a scale from 1 (weakest) to 12 (strongest).Results: Studies reported correlations between QoL scores and Visual Structure. Associations were also reported between QoL and Visual Function both cross-sectionally and longitudinally, with a stronger association of VF and VA with distance activities (average ranking 9.1 and 9.6), vision-specific dependency (8.7 and 8.9), and driving (8.6 and 9.7). Vision-specific mental health (6.5 and 4.9), vision-specific social functioning (8.4 and 6.2), and vision-specific role difficulties (7.1 and 6.6) domains were more associated with VF than with VA.Conclusion: Our study was the first to quantify and rank the strength of association between visual function and QoL domains. Driving and psycho-social QoL domains tended to be most affected by glaucoma-related deterioration of visual function. QoL scores could be used for more patient-centered disease management.
Collapse
Affiliation(s)
- Naira Khachatryan
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Maxwell Pistilli
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Maureen G Maguire
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Angela Y Chang
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Marissa R Samuels
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kristen Mulvihill
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca J Salowe
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Joan M O'Brien
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
15
|
Liao KM, Wu WC, Jang Y, Su FY, Tsai LT. Impacts of monocular, binocular, and functional visual acuity on vision-related quality of life in patients with type 2 diabetes. Sci Rep 2021; 11:298. [PMID: 33431910 PMCID: PMC7801718 DOI: 10.1038/s41598-020-79483-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/09/2020] [Indexed: 11/09/2022] Open
Abstract
Although the association between visual acuity (VA) and vision-related quality of life (VRQoL) has been well reported in patients with type 2 diabetes mellitus (T2DM), little is known about how unilateral and bilateral VA affects daily performance in such patients. For this cross-sectional study, patients were recruited from the Diabetes Shared Care Network of the Division of Endocrinology and Metabolism, Zhong-Xiao Branch, Taipei City Hospital in Taiwan. Ninety patients with T2DM (51 men and 39 women) with a mean age of 60.3 ± 10.5 (standard deviation) years, 47% of whom had diabetic retinopathy, were included. The purposes were to compare the impacts of VA in the better eye, both eyes, and three forms of functional acuity scores (FAS) on VRQoL in patients with T2DM. VRQoL and corrected VA were assessed with the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Early Treatment Diabetic Retinopathy Study (ETDRS) chart, respectively. Three FAS algorithms proposed by Colenbrander and the American Medical Association were used to assess FAS. Regression analyses were performed to determine the correlations among the five types of VA, the original composite scores, and the Rasch-calibrated composite scores of the NEI VFQ-25 on all patients with T2DM and on the same patients stratified by diabetic retinopathy (DR) and no-DR. The VA of both eyes had a higher impact on VRQoL and revealed a lower reduction estimated by the two forms of composite scores than did the VA of the better eye and three FAS algorithms (compared with binocular VA β estimates, − 14.5%, − 15.8%, − 29.3%, and − 11.8% for original composite scores, and − 16.1%, − 14.0%, − 24.6%, and 10.3% for Rasch-calibrated composite scores). When the T2DM group was stratified into DR and no-DR groups, significant associations between VA and VRQoL were observed only in the DR group. The VA of both eyes also had the greatest impact and reduction after stratification. The results indicated that unilateral better-eye VA and VA estimated by the three FAS algorithms seems to underestimate the impact of visual impairment on self-report VRQoL in patients with T2DM. This study provides empirical support for the importance of binocular VA assessment in regular clinical diabetes eye care.
Collapse
Affiliation(s)
- Kuo-Meng Liao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Zhong-Xiao Branch, Taipei City Hospital, Taipei, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital and Chang Gung University, School of Medicine, Taoyuan, Taiwan
| | - Yuh Jang
- School of Occupational Therapy, College of Medicine, National Taiwan University, 4F, No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan
| | - Fan-Ya Su
- Department of Psychiatry, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Li-Ting Tsai
- School of Occupational Therapy, College of Medicine, National Taiwan University, 4F, No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
| |
Collapse
|
16
|
Mohammadzadeh V, Fatehi N, Yarmohammadi A, Lee JW, Sharifipour F, Daneshvar R, Caprioli J, Nouri-Mahdavi K. Macular imaging with optical coherence tomography in glaucoma. Surv Ophthalmol 2020; 65:597-638. [PMID: 32199939 PMCID: PMC7423773 DOI: 10.1016/j.survophthal.2020.03.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
With the advent of spectral-domain optical coherence tomography, imaging of the posterior segment of the eye can be carried out rapidly at multiple anatomical locations, including the optic nerve head, circumpapillary retinal nerve fiber layer, and macula. There is now ample evidence to support the role of spectral-domain optical coherence tomography imaging of the macula for detection of early glaucoma. Macular spectral-domain optical coherence tomography measurements demonstrate high reproducibility, and evidence on its utility for detection of glaucoma progression is accumulating. We present a comprehensive review of macular spectral-domain optical coherence tomography imaging emerging as an essential diagnostic tool in glaucoma.
Collapse
Affiliation(s)
- Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Nima Fatehi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA; Saint Mary Medical Center - Dignity Health, Long Beach, California, USA
| | - Adeleh Yarmohammadi
- Shiley Eye Institute, University of California, San Diego, La Jolla, California, United States
| | - Ji Woong Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Farideh Sharifipour
- Department of Ophthalmology, Shahid Beheshti university of Medical Sciences, Tehran, Iran
| | - Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
| |
Collapse
|
17
|
Hirji SH, Liebmann JM, Hood DC, Cioffi GA, Blumberg DM. Macular Damage in Glaucoma is Associated With Deficits in Facial Recognition. Am J Ophthalmol 2020; 217:1-9. [PMID: 32360859 DOI: 10.1016/j.ajo.2020.04.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This report examines the relationship between glaucomatous macular damage and facial recognition. In addition, it assesses the role of contrast sensitivity (CS) as an intermediary step in the causal pathway between macular damage and impairment of facial recognition. DESIGN Prospective cross-sectional study. METHODS This study was conducted in a single tertiary care center. The study population included 144 eyes of 72 participants with a diagnosis of open angle glaucoma in one or both eyes and a visual acuity of 20/40 or better in each eye. The presence or absence of macular damage was determined by comparing corresponding regions of the retinal nerve fiber layer and the retinal ganglion cell layer with spectral-domain optical coherence tomography with the 10-2 visual field (VF). Better and worse eye was determined by 10-2 VF mean deviations (MDs). Interventions were 1) macular function as measured by 10-2 VF and 2) CS as measured by the Freiburg Visual Acuity and Contrast Test (FrACT). The primary outcome measure was the Cambridge Face Memory Test (CFMT) score. RESULTS Regardless of eye, there was a significant correlation between facial recognition and 10-2 VF MD (P < .0001 better, worse eye). The 10-2 VF MD remained a significant predictor of facial recognition after adjusting for potential confounders including glaucoma severity, CS, age, and visual acuity (P = .004 better eye, P = .019 worse eye). CONCLUSIONS Even with good central visual acuity, patients with glaucomatous macular damage exhibit diminished facial recognition, which is partly mediated through diminished CS.
Collapse
|
18
|
De Moraes CG, Paula JS, Blumberg DM, Cioffi GA, Al-Aswad LA, Girkin CA, Weinreb RN, Zangwill LM, Ritch R, Susanna R, Hood DC, Liebmann JM. Detection of Progression With 10-2 Standard Automated Perimetry: Development and Validation of an Event-Based Algorithm. Am J Ophthalmol 2020; 216:37-43. [PMID: 32278773 DOI: 10.1016/j.ajo.2020.03.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/21/2020] [Accepted: 03/31/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the development of a new algorithm for detecting progressive changes in 10-2 visual field (VF) tests using event-based analysis and to test its validity in a second, independent glaucoma cohort. DESIGN Prospective cohort study. METHODS Patients with established open-angle glaucoma from the Macular Assessment and Progression Study (MAPS; development cohort, n = 151), and the African Descent and Glaucoma Evaluation Study (ADAGES; validation cohort, n = 52) were evaluated. The 10-2 VF results from MAPS were obtained during 4 test-retest sessions within a 4-month period. For the validation analysis, 10-2 VF results from ADAGES performed on at least 5 visits were used. The event-based pointwise changes on 10-2 tests in the validation cohort were determined using 2 progression criteria: at least 3 progressing VF locations on 2 or 3 consecutive tests ("possible" or "likely" progression). Linear mixed-effects models were used to evaluate VF progression. RESULTS In the validation cohort, the mean (SD) follow-up time was 2.3 (0.7) years. The number of eyes experiencing 10-2 VF progression based on "possible" and "likely" progression was 36 (54.5%) and 11 (16.6%), respectively. Eyes experiencing "possible" progression had MD changes (-0.60 dB/year [95% confidence interval (CI): -0.93 to -0.28]) faster than those not meeting this criterion (P < .001), whereas for those with "likely" progression the difference was -0.91 dB/year (95% CI: -1.26 to -0.56, P < .001). CONCLUSIONS A new event-based progression algorithm using the 10-2 VF can identify eyes experiencing more rapid MD progression and may be used as a tool to assess progressive macular functional changes in glaucoma.
Collapse
Affiliation(s)
- Carlos Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA; Department of Ophthalmology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
| | - Jayter Silva Paula
- Department of Ophthalmology, Otorhinolaryngology and Head Neck Surgery, Ribeirao Preto Medical School - University of Sao Paulo, Ribeirao Preto, Brazil
| | - Dana M Blumberg
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
| | - George A Cioffi
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
| | - Lama A Al-Aswad
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
| | - Christopher A Girkin
- Department of Ophthalmology, University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California-San Diego, San Diego, California, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California-San Diego, San Diego, California, USA
| | - Robert Ritch
- Einhorn Clinical Research Center, Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
| | - Remo Susanna
- Department of Ophthalmology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Donald C Hood
- Department of Psychology, Columbia University, New York, New York, USA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
| |
Collapse
|
19
|
Hood DC, Zemborain ZZ, Tsamis E, De Moraes CG. Improving the Detection of Glaucoma and Its Progression: A Topographical Approach. J Glaucoma 2020; 29:613-621. [PMID: 32459689 PMCID: PMC7423747 DOI: 10.1097/ijg.0000000000001553] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Glaucoma is typically defined as a progressive optic neuropathy characterized by a specific (arcuate) pattern of visual field (VF) and anatomic changes. Therefore, we should be comparing arcuate patterns of damage seen on VFs with those seen on optical coherence tomography (OCT) maps. Instead, clinicians often use summary metrics such as VF pattern standard deviation, OCT retinal nerve fiber (RNF) global thickness, etc. There are 2 major impediments to topographically comparing patterns of damage on VF and OCT maps. First, until recently, it was not easy to make these comparisons with commercial reports. While recent reports do make it easier to compare VF and OCT maps, they have shortcomings. In particular, the 24-2 VF covers a larger retinal region than the commercial OCT scans, and, further, it is not easy to understand the topographical relationship among the different maps/plots within the current OCT reports. Here we show how a model of RNF bundles can overcome these problems. The second major impediment is the lack of a quantitative, and automated, method for comparing patterns of damage seen on VF and OCT maps. However, it is now possible to objectively and automatically quantify this agreement. Together, the RNF bundle model and the automated structure-function method should improve the power of topographical methods for detecting glaucoma and its progression. This should prove useful in clinical studies and trials, as well as for training and validating artificial intelligence/deep learning approaches for these purposes.
Collapse
Affiliation(s)
- Donald C. Hood
- Department of Psychology, Columbia University, New York City, NY, USA
- Department of Ophthalmology, Columbia University Medical Center, New York City, New York, USA
| | - Zane Z. Zemborain
- Department of Psychology, Columbia University, New York City, NY, USA
| | - Emmanouil Tsamis
- Department of Psychology, Columbia University, New York City, NY, USA
| | - C. Gustavo De Moraes
- Department of Ophthalmology, Columbia University Medical Center, New York City, New York, USA
| |
Collapse
|
20
|
Point-wise correlations between 10-2 Humphrey visual field and OCT data in open angle glaucoma. Eye (Lond) 2020; 35:868-876. [PMID: 32483310 PMCID: PMC8027206 DOI: 10.1038/s41433-020-0989-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 05/01/2020] [Accepted: 05/18/2020] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Optical Coherence Tomography (OCT) is a powerful instrument for helping clinicians detect and monitor glaucoma. The aim of this study was to provide a detailed mapping of the relationships between visual field (VF) sensitivities and measures of retinal structure provided by a commercial Spectral Domain (SD)-OCT system (RTvue-100 Optovue). METHODS Sixty-three eyes of open angle glaucoma patients (17 males, 16 females, and mean age 71 ± 7.5 years) were included in this retrospective, observational clinical study. Thickness values for superior and inferior retina, as well as average values, were recorded for the full retina, the outer retina, the ganglion cell complex, and the peripapillary retinal nerve fiber layer (RNFL). RNFL thickness was further evaluated along eight separate sectors (temporal lower, temporal upper, superior temporal, superior nasal, nasal upper, nasal lower, inferior nasal, and inferior temporal). Point-wise correlations were then computed between each of these OCT measures and the visual sensitivities at all VF locations assessed via Humphrey 10-2 and 24-2 perimetry. Lastly, OCT data were fit to VF data to predict glaucoma stage. RESULTS The relationship between retinal thickness and visual sensitivities reflects the known topography of the retina. Spatial correlation patterns between visual sensitivities and RNFL thickness along different sectors broadly agree with previously hypothesized structure-function maps, yet suggest that structure-function maps still require more precise characterizations. Given these relationships, we find that OCT data can predict glaucoma stage. CONCLUSION Ganglion cell complex and RNFL thickness measurements are highlighted as the most promising candidate metrics for glaucoma detection and monitoring.
Collapse
|
21
|
Shukla AG, De Moraes CG, Cioffi GA, Girkin CA, Weinreb RN, Zangwill LM, Liebmann JM. The Relationship Between Intraocular Pressure and Rates of Central Versus Peripheral Visual Field Progression. J Glaucoma 2020; 29:435-440. [PMID: 32251071 PMCID: PMC7272279 DOI: 10.1097/ijg.0000000000001494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PRECIS In this longitudinal prospective cohort study of open-angle glaucoma patients, intraocular pressure (IOP) parameters (mean, fluctuation, and maximum) had a similar effect on glaucomatous progression in the central and peripheral visual field (VF) regions. PURPOSE To study the effects of IOP on rates of glaucomatous central versus peripheral VF progression. METHODS The African Descent and Glaucoma Evaluation Study (ADAGES) is a longitudinal prospective cohort study that recruited patients from 3 centers. A sample of those with established glaucoma were included in this study. The mean peripheral sensitivity (MPS) and the mean central sensitivity (MCS) were defined based upon the average total deviation of the peripheral and central (10 degrees) points of the 24-2 VF, respectively. Progression was based upon central and peripheral change from linear mixed-effects models. The relationships between VF progression and IOP mean, maximum, and fluctuation as continuous variables were also investigated. Main outcome measures were MPS and MCS progression rates. RESULTS A total of 452 eyes of 344 patients were studied. The mean number of VFs (SD) for each eye was 13.3 (6.4) over 9.1 (3.7) years. The mean baseline MD was -5.1 (3.9) dB and the mean rate of MD change was -0.26 dB/y [95% confidence interval (CI): -0.33 to -0.20, P<0.001]. Mean rates of MPS (-0.27 dB/y, 95% CI: -0.33 to -0.22, P<0.001) and MCS change (-0.26 dB/y, 95% CI: -0.31 to -0.21, P<0.001) were similar (P=0.351). Mean, fluctuation, and maximum IOP were significantly associated with MPS and MCS (all P<0.025). CONCLUSIONS The effect of IOP parameters on VF progression was statistically similar between central and peripheral VF regions.
Collapse
Affiliation(s)
- Aakriti G Shukla
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
| | - C Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
| | - George A Cioffi
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
| | | | - Robert N Weinreb
- Department of Ophthalmology, Hamilton Glaucoma Center, University of California-San Diego, San Diego, CA
| | - Linda M Zangwill
- Department of Ophthalmology, Hamilton Glaucoma Center, University of California-San Diego, San Diego, CA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
| |
Collapse
|
22
|
Zhang Y, Bian A, Hang Q, Zhou Q. Optical Quality Assessed by Optical Quality Analysis System in Chinese Primary Open-Angle Glaucoma Patients and Its Correlations with Psychological Disturbances and Vision-Related Quality of Life. Ophthalmic Res 2020; 64:15-21. [PMID: 32172234 DOI: 10.1159/000507220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/10/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate if optical quality assessed by Optical Quality Analysis System (OQAS) is a new factor for psychological disturbance and vision-related quality of life (QoL) in Chinese patients with primary open-angle glaucoma (POAG). METHODS This is a cross-sectional study. OQAS, automated static perimetry, the Hospital Anxiety and Depression Scale (HADS) Questionnaire, and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) were used to assess optical quality, visual field, psychological health, and QoL in 64 POAG patients. Correlation between the OQAS parameters and QoL or psychological health was analyzed by linear regression model. RESULTS OQAS parameters, the modulation transfer function cutoff frequency (MTF cutoff) and the mean OQAS values (mean OV) were significantly related to mean deviation (MD). Statistically significant correlation was also found between MTF cutoff, the mean OV, and QoL in more than half of the NEI VFQ-25 subscale scores and the composite. The correlation coefficients between OQAS parameters and QoL were similar to those between MD and QoL in most of the subscale scores. HADS-Depression and HADS-Anxiety scores significantly correlated with MD in the worse eye, the composite and 3 subscales of NEI VFQ-25, general health, social function, and mental health, but were not correlated with optical quality parameters measured by OQAS. CONCLUSIONS OQAS-assessed optical quality is negatively related to MD and is a valid indicator for vision-related QoL, but not for psychological health in our study group. OQAS might be an alternative or supplement to perimeter in POAG patients.
Collapse
Affiliation(s)
- Yang Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ailing Bian
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qijun Hang
- Department of Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Qi Zhou
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China,
| |
Collapse
|
23
|
Diffuse Macular Damage in Mild to Moderate Glaucoma Is Associated With Decreased Visual Function Scores Under Low Luminance Conditions. Am J Ophthalmol 2019; 208:415-420. [PMID: 31493403 DOI: 10.1016/j.ajo.2019.08.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Glaucoma patients commonly report increasing visual problems under low luminance or glare conditions, yet there is limited understanding of the structural basis of visual functional losses. This report examines the relationship between glaucomatous macular damage, assessed using structure-function correlation, and visual difficulty under low luminance conditions, as measured by Low Luminance Questionnaire (LLQ). DESIGN Observational cohort study. METHODS Setting: Tertiary care referral center. PARTICIPANTS A total of 252 eyes of 126 participants with mild or moderate open-angle glaucoma (24-2 mean deviation [MD] better than -12 dB) selected from a consecutive sample. PREDICTOR Focal and diffuse macular defects were identified based on corresponding abnormal regions on probability maps from spectral-domain optical coherence tomography (SDOCT) optic disc and macular cube scans, and 10-2 and 24-2 visual fields (VF). MAIN OUTCOME MEASURE LLQ scores. RESULTS Eighty-two of the 126 (65%) better eyes (defined by 24-2 VF MD) had evidence of macular damage, while the remaining 44 did not have macular damage. Of the 82 with damage, 33 (40%) had diffuse damage and 49 (60%) had focal damage. After adjusting for 24-2 MD and age in the multivariable regression, diffuse macular damage remained a significant predictor of the LLQ subscales "difficulty with extreme lighting" (P = .0024), ''difficulty with low lighting" (P = .037), and "diminished mobility"; (P = .042). In contrast, there was no significant difference in LLQ scores in any subscale between participants with focal macular damage and those without macular damage. CONCLUSION Mild diffuse glaucomatous macular damage, as detected by abnormal topographic regions on measures of structure and function, is associated with decreased LLQ scores.
Collapse
|
24
|
The Optimal Diameter for Circumpapillary Retinal Nerve Fiber Layer Thickness Measurement by SD-OCT in Glaucoma. J Glaucoma 2019; 27:1086-1093. [PMID: 30036293 DOI: 10.1097/ijg.0000000000001027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the diagnostic power for glaucoma detection using circumpapillary retinal nerve fiber layer (cRNFL) thickness in 3 diameter sizes from the center of the optic nerve head (ONH) by spectral domain optical coherence tomography. PATIENTS AND METHODS In this cross-sectional study, case-control, 437 eyes diagnosed with glaucoma and 183 eyes of healthy controls underwent spectral domain optical coherence tomography of the ONH, visual field testing, and a clinical examination. cRNFL was measured by circular scans in 3.5 (C1), 4.1 (C2), and 4.7 mm (C3) distance from the center of the ONH. Receiver-operator characteristic analysis was used to assess diagnostic power to detect glaucoma; furthermore, patient-specific maximum localized damage was analyzed. RESULTS In C1, mean global cRNFL was 70.03±18.2 μm in glaucomatous eyes and 93.46±9.9 μm in controls. Respectively, cRNFL in C2 was 61.39±14.9 and 80.43±8.4 μm as well as 55.25±12.8 and 70.70±6.7 μm in C3. Using receiver-operator characteristic analysis, the area under the curve (AUC) for cRNFL was 0.855 in C1, 0.850 in C2, and 0.843 in C3. Mean AUCs in ONH sectors ranged from 0.699 to 0.846 and did not exceed AUC of the best scoring global parameter. CONCLUSIONS Comparing 3.5, 4.1, and 4.7 mm diameters for cRNFL measurement, the inner circle at 3.5 mm distance showed the highest AUC to differentiate glaucoma from healthy controls. However, levels of diagnostic power from wider circular scans were not significantly different and were comparable. Moreover, sectorial cRNFL measurements were nonsuperior. The use of the ONH sector with the highest localized damage seems not to increase diagnostic power.
Collapse
|
25
|
Vision-related Performance and Quality of Life of Patients With Rapid Glaucoma Progression. J Glaucoma 2019; 28:216-222. [DOI: 10.1097/ijg.0000000000001179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Garg A, Hood DC, Pensec N, Liebmann JM, Blumberg DM. Macular Damage, as Determined by Structure-Function Staging, Is Associated With Worse Vision-related Quality of Life in Early Glaucoma. Am J Ophthalmol 2018; 194:88-94. [PMID: 30053467 DOI: 10.1016/j.ajo.2018.07.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/08/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Macular damage is common early in glaucoma and has previously been identified as a significant factor affecting vision-related quality of life (VRQoL) across the spectrum of glaucomatous damage. This report uses structure-function correlation to identify early macular damage and assess its relationship with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). DESIGN Cohort study. METHODS Setting: Institutional. STUDY POPULATION Eighty-eight eyes of 44 participants with early open-angle glaucoma (24-2 mean deviation [MD] better than -6 dB). OBSERVATION PROCEDURE Focal and diffuse macular defects were identified based on corresponding abnormal regions on probability maps from spectral-domain optical coherence tomography (SD-OCT) optic disc and macular cube scans, and 10-2 and 24-2 visual fields (VF). MAIN OUTCOME MEASURE VRQoL, as measured by the NEI VFQ-25. RESULTS Twenty-five of 44 (57%) "worse" eyes (defined by 24-2 VF MD) and 13 of 44 (31%) "better" eyes had macular damage. Mean (±standard deviation) MD of worse and better eyes were -3.03 dB (±2.3) and -1.15 dB (±1.7), respectively. Compared to those without macular damage, lower NEI VFQ-25 scores were seen in patients with macular damage in the worse eye (85.4 [± 9.0] vs 94.6 [± 3.3]; P = .0001) and the better eye (84.8 [± 11.1] vs 91.3 [± 6.3]; P = .017). Arcuate damage outside the macula did not affect VRQoL (better eye, P = .40; worse eye, P = .87). CONCLUSIONS Early glaucomatous macular damage, as detected by abnormal topographic regions on measures of structure and function, is associated with decreased VRQoL. Arcuate damage outside the macula does not have an association with VRQoL in early glaucoma.
Collapse
|
27
|
Kung Y, Takusagawa H. Update on Quality of Life in Glaucoma. CURRENT OPHTHALMOLOGY REPORTS 2018. [DOI: 10.1007/s40135-018-0169-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
28
|
Wu Z, Weng DSD, Thenappan A, Ritch R, Hood DC. Evaluation of a Region-of-Interest Approach for Detecting Progressive Glaucomatous Macular Damage on Optical Coherence Tomography. Transl Vis Sci Technol 2018; 7:14. [PMID: 29616153 PMCID: PMC5879991 DOI: 10.1167/tvst.7.2.14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/11/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate a manual region-of-interest (ROI) approach for detecting progressive macular ganglion cell complex (GCC) changes on optical coherence tomography (OCT) imaging. Methods One hundred forty-six eyes with a clinical diagnosis of glaucoma or suspected glaucoma with macular OCT scans obtained at least 1 year apart were evaluated. Changes in the GCC thickness were identified using a manual ROI approach (ROIM), whereby region(s) of observed or suspected glaucomatous damage were manually identified when using key features from the macular OCT scan on the second visit. Progression was also evaluated using the global GCC thickness and an automatic ROI approach (ROIA), where contiguous region(s) that fell below the 1% lower normative limit and exceeded 288 μm2 in size were evaluated. Longitudinal signal-to-noise ratios (SNRs) were calculated for progressive changes detected by each of these methods using individualized estimates of test–retest variability and age-related changes, obtained from 303 glaucoma and 394 healthy eyes, respectively. Results On average, the longitudinal SNR for the global thickness, ROIA and ROIM methods were −0.90 y−1, −0.91 y−1, and −1.03 y−1, respectively, and was significantly more negative for the ROIM compared with the global thickness (P = 0.003) and ROIA methods (P = 0.021). Conclusions Progressive glaucomatous macular GCC changes were optimally detected with a manual ROI approach. Translational Relevance These findings suggests that an approach based on a qualitative evaluation of OCT imaging information and consideration of known patterns of damage can improve the detection of progressive glaucomatous macular damage.
Collapse
Affiliation(s)
- Zhichao Wu
- Department of Psychology, Columbia University, New York, NY, USA.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.,Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Denis S D Weng
- Department of Psychology, Columbia University, New York, NY, USA
| | | | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Donald C Hood
- Department of Psychology, Columbia University, New York, NY, USA.,Department of Ophthalmology, Columbia University, New York, NY, USA
| |
Collapse
|
29
|
Baseline 24-2 Central Visual Field Damage Is Predictive of Global Progressive Field Loss. Am J Ophthalmol 2018; 187:92-98. [PMID: 29317211 DOI: 10.1016/j.ajo.2018.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 12/27/2017] [Accepted: 01/01/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Central visual field (VF) damage in glaucoma patients can significantly hinder daily activities. The present study investigates whether the presence of localized baseline damage to the central 10 degrees of the VF is predictive of faster global mean deviation (MD) progression. DESIGN Prospective cohort study. METHODS Eyes from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES) with established glaucoma and VF loss and a minimum of 5 24-2 VFs were eligible. Baseline central 24-2 damage was defined as any of the 12 central-most points with total deviation (TD) values at P < 0.5% on 2 consecutive examinations. Progression was determined using trend-based and event-based criteria: (1) rates of MD change significantly faster than zero and (2) >-5 dB MD loss over the entire follow-up. RESULTS A total of 827 eyes of 584 patients were studied. Mean rate of MD change of the entire sample was -0.15 dB/year (95% CI: -0.19 to -0.12, P < .001). Eyes with baseline central damage progressed faster than those without (difference: βcentral = -0.07 dB/year, 95% CI: -0.11 to -0.01, P = .011) and were more likely to experience MD loss greater than 5 dB (hazard ratio = 3.0 [95% CI: 2.1-4.1, P < .001]). These differences remained significant after adjusting for confounders. CONCLUSION The presence of central VF damage at baseline is significantly associated with more rapid global progression. Detection of central VF damage aids in stratification of high-risk patients who may need intensive surveillance and aggressive treatment.
Collapse
|