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목적 : To evaluate the progressive changes of circumpapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses measured by spectral-domain optical coherence tomography (Cirrus SD-OCT) in open-angle glaucoma with localized RNFL defect.
방법 : Open-angle glaucoma patients with localized RNFL defect who had four years’ worth of annual RNFL photography and OCT measurements were enrolled. We defined the progressor group according to structural progression by optic disc and RNFL photography. The progression rates of non-progressor and progressor patients’ serial circumpapillary RNFL and macular GCIPL thicknesses (µm), angular width (°), and area (mm2) of defect on RNFL and GCIPL deviation maps were determined by linear mixed-effect models. Annual changes of the RNFL and GCIPL parameters were evaluated by paired t-test.
결과 : Relative to the non-progressors, the progressors showed significantly higher progression rates in average, 6 and 11 o’clock sector RNFL thicknesses, angular width and area of defect in RNFL deviation map, as well as inferotemporal and minimum GCIPL thicknesses. The thicknesses of the 6 o’clock sector RNFL and minimum GCIPL exhibited the highest reduction rates among the RNFL and GCIPL parameters assessed, respectively. When comparing the baseline with year 1, the changes of RNFL thickness first appeared in the inferior quadrant, especially in the 5 or 6 o’clock sector. As for the GCIPL, angular width and area of defect in deviation map and the thicknesses of all sectors excepting the superior sector showed significant reductions at year 1 relative to the baseline.
결론 : When evaluating structural glaucoma progression by OCT, careful observation of the average, 6 and 11 o’clock sectors in RNFL and inferotemporal and minimum GCIPL thicknesses can be helpful. Interestingly, even non-progressors, as determined by structural criteria, showed significant OCT changes over time. We can effectively assess early changes of glaucoma progression with GCIPL thickness as well as RNFL thickness.
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