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Structural characteristics of the acquired optic disc pit and the rate of progressive retinal nerve fiber layer thinning in primary open-angle glaucoma.

Abstract The optic disc pit (ODP) has been considered a region of localized susceptibility to the damage of glaucoma.
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Keywords
Journal Title jama ophthalmology
Publication Year Start




PMID- 26247160
OWN - NLM
STAT- MEDLINE
DA  - 20151009
DCOM- 20160115
LR  - 20151009
IS  - 2168-6173 (Electronic)
IS  - 2168-6165 (Linking)
VI  - 133
IP  - 10
DP  - 2015 Oct
TI  - Structural characteristics of the acquired optic disc pit and the rate of
      progressive retinal nerve fiber layer thinning in primary open-angle glaucoma.
PG  - 1151-8
LID - 10.1001/jamaophthalmol.2015.2453 [doi]
AB  - IMPORTANCE: The optic disc pit (ODP) has been considered a region of localized
      susceptibility to the damage of glaucoma. OBJECTIVE: To determine whether the
      rate of retinal nerve fiber layer (RNFL) thinning differs according to the
      presence and structural characteristics of an ODP in primary open-angle glaucoma.
      DESIGN, SETTING, AND PARTICIPANTS: We performed a prospective case-control study 
      that included 163 eyes with primary open-angle glaucoma (83 with an ODP and 80
      without an ODP) from Glaucoma Clinic of Seoul National University Bundang
      Hospital. Participants were enrolled from the ongoing Investigating Glaucoma
      Progression Study from January 1, 2012, through May 31, 2014. Mean (SD) follow-up
      was 3.32 (0.49) years (through May 31, 2014). Optic nerve heads underwent
      swept-source optical coherence tomography (OCT) to determine the presence of
      focal lamina cribrosa alteration and its structural characteristics. Eyes with
      and without photographic ODPs and corresponding microscopic laminar alterations
      were assigned to the ODP and non-ODP groups, respectively. The rates of
      progressive thinning of global and 6 sectoral spectral-domain OCT RNFL
      thicknesses were determined by linear regression and compared between the 2
      groups. We used a general linear model to determine the factors associated with
      the rate of RNFL thinning; data obtained from September 21, 2009, through May 31,
      2014, were used to calculate the rate of RNFL thinning. MAIN OUTCOMES AND
      MEASURES: The relationship between the presence and structural characteristics of
      ODPs and the rate of progressive OCT RNFL thinning. RESULTS: Thinning of the RNFL
      was faster in the ODP group than in the non-ODP group in the global (mean [SD],
      -1.44 [1.31] vs -0.93 [1.10] [95% CI, -0.97 to -0.19] mum/y; P = .008),
      temporoinferior (mean [SD], -4.17 [4.15] vs -1.97 [3.26] [95% CI, -3.36 to -1.04]
      mum/y; P < .001), and temporal (mean [SD], -1.92 [2.62] vs -0.89 [1.62] [95% CI, 
      -1.70 to -0.35] mum/y; P = .003) sectors. The rate of RNFL thinning was maximum
      in the temporoinferior sector (mean [SD], -4.17 [4.15] mum/y) and corresponded to
      the frequency distribution of ODPs. Regression analysis revealed that faster
      global RNFL thinning was related to a higher untreated intraocular pressure (beta
      = -0.07; 95% CI, -0.11 to -0.03; P = .001), episodes of disc hemorrhage (beta =
      -0.74; 95% CI, -1.79 to 0.31; P = .003), the presence of beta-zone parapapillary 
      atrophy (beta = -0.47; 95% CI, -1.13 to 0.20; P = .02), and the presence of ODPs 
      (beta = -0.41; 95% CI, -1.14 to 0.32; P = .02). The maximum rate of RNFL thinning
      was associated with higher untreated intraocular pressure (beta = -0.24; 95% CI, 
      -0.35 to -0.13; P < .001), disc hemorrhage (beta = -1.54; 95% CI, -2.88 to -0.19;
      P < .001), and the presence (beta = -1.04; 95% CI, -2.14 to 0.07; P = .004),
      far-peripheral location (beta = -1.75; 95% CI, -3.05 to -0.46; P = .008), and
      partial-thickness depth (beta = -1.45; 95% CI, -2.75 to -0.16; P = .03) of an
      ODP. CONCLUSIONS AND RELEVANCE: The presence and structural characteristics of
      ODPs were associated with global and focal progression as assessed by the rate of
      OCT RNFL thinning. The assessment of ODP structure using swept-source OCT may
      help to predict the location of future progression.
FAU - Lee, Seung Hyen
AU  - Lee SH
AD  - Department of Ophthalmology, Seoul National University College of Medicine, Seoul
      National University Bundang Hospital, Seongnam, Korea.
FAU - Lee, Eun Ji
AU  - Lee EJ
AD  - Department of Ophthalmology, Seoul National University College of Medicine, Seoul
      National University Bundang Hospital, Seongnam, Korea.
FAU - Kim, Tae-Woo
AU  - Kim TW
AD  - Department of Ophthalmology, Seoul National University College of Medicine, Seoul
      National University Bundang Hospital, Seongnam, Korea.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JAMA Ophthalmol
JT  - JAMA ophthalmology
JID - 101589539
RN  - Glaucoma, Primary Open Angle
SB  - AIM
SB  - IM
MH  - Aged
MH  - Case-Control Studies
MH  - Disease Progression
MH  - Eye Abnormalities/*diagnosis
MH  - Female
MH  - Follow-Up Studies
MH  - Glaucoma, Open-Angle/*diagnosis
MH  - Humans
MH  - Intraocular Pressure
MH  - Male
MH  - Middle Aged
MH  - Nerve Fibers/*pathology
MH  - Optic Disk/*abnormalities
MH  - Photography
MH  - Prospective Studies
MH  - Retinal Ganglion Cells/*pathology
MH  - Tomography, Optical Coherence
MH  - Visual Field Tests
MH  - Visual Fields
EDAT- 2015/08/08 06:00
MHDA- 2016/01/16 06:00
CRDT- 2015/08/07 06:00
AID - 2422114 [pii]
AID - 10.1001/jamaophthalmol.2015.2453 [doi]
PST - ppublish
SO  - JAMA Ophthalmol. 2015 Oct;133(10):1151-8. doi: 10.1001/jamaophthalmol.2015.2453.