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      Associations of Ganglion Cell-Inner Plexiform Layer and Optic Nerve Head Parameters with Visual Field Sensitivity in Advanced Glaucoma

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          Abstract

          Purpose: To evaluate the associations of optical coherence tomography (OCT)-derived macular ganglion cell-inner plexiform layer thickness (mGCIPLT), circumpapillary retinal nerve fiber layer thickness (cpRNFLT), and optic nerve head (ONH) parameters with visual field (VF) sensitivity in advanced glaucoma. Methods: In this cross-sectional study, 102 eyes from 102 patients with advanced glaucoma (defined as a 24-2 VF mean deviation (MD) of ≤−12 dB) were included. mGCIPLT, cpRNFLT, and ONH parameters (including the rim area, average cup-to-disc [C:D] ratio, and vertical C:D ratio) were measured using Cirrus high-definition OCT, and 24-2 and 10-2 VF sensitivity tests were performed using standard automated perimetry. Pearson correlations and linear models were used to analyze relationships between OCT-derived parameters and VF parameters. Results: The mGCIPLT and rim area were significantly positively correlated with the 24-2 VF MD, 24-2 VF pattern standard deviation, 24-2 VF visual field index, and 10-2 VF MD, but cpRNFLT was not significantly correlated with VF parameters. In addition, the average and vertical C:D ratios were significantly negatively correlated with VF parameters. The mGCIPLT and rim area were significantly positively correlated with the 10-2 VF MD ( r ranging between 0.542 and 0.621, p < 0.001), while the average and vertical C:D ratios were significantly negatively correlated with the 10-2 VF MD ( r = −0.537, p < 0.001, and r = −0.428, p < 0.001, respectively). Each 1-µm change in the average mGCIPLT was associated with an approximately 0.368-dB change in the 24-2 VF MD and 0.677-dB change in the 10-2 VF MD ( R<sup>2</sup> = 0.268, p < 0.001, and R<sup>2</sup> = 0.385, p < 0.001, respectively). The 10-2 VF MD showed a significantly stronger association with inferonasal mGCIPLT than did the 24-2 VF MD in advanced glaucoma ( p = 0.007). Conclusions: mGCIPLT and ONH parameters were associated with the severity of VF damage and reflected functional damage better than cpRNFLT in advanced glaucoma. Our results suggested that structural measurements of mGCIPLT and ONH parameters and functional measurement of the 10-2 VF may be useful for monitoring progression in advanced glaucoma.

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          Most cited references54

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          Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis.

          Glaucoma is the leading cause of global irreversible blindness. Present estimates of global glaucoma prevalence are not up-to-date and focused mainly on European ancestry populations. We systematically examined the global prevalence of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and projected the number of affected people in 2020 and 2040. Systematic review and meta-analysis. Data from 50 population-based studies (3770 POAG cases among 140,496 examined individuals and 786 PACG cases among 112 398 examined individuals). We searched PubMed, Medline, and Web of Science for population-based studies of glaucoma prevalence published up to March 25, 2013. Hierarchical Bayesian approach was used to estimate the pooled glaucoma prevalence of the population aged 40-80 years along with 95% credible intervals (CrIs). Projections of glaucoma were estimated based on the United Nations World Population Prospects. Bayesian meta-regression models were performed to assess the association between the prevalence of POAG and the relevant factors. Prevalence and projection numbers of glaucoma cases. The global prevalence of glaucoma for population aged 40-80 years is 3.54% (95% CrI, 2.09-5.82). The prevalence of POAG is highest in Africa (4.20%; 95% CrI, 2.08-7.35), and the prevalence of PACG is highest in Asia (1.09%; 95% CrI, 0.43-2.32). In 2013, the number of people (aged 40-80 years) with glaucoma worldwide was estimated to be 64.3 million, increasing to 76.0 million in 2020 and 111.8 million in 2040. In the Bayesian meta-regression model, men were more likely to have POAG than women (odds ratio [OR], 1.36; 95% CrI, 1.23-1.52), and after adjusting for age, gender, habitation type, response rate, and year of study, people of African ancestry were more likely to have POAG than people of European ancestry (OR, 2.80; 95% CrI, 1.83-4.06), and people living in urban areas were more likely to have POAG than those in rural areas (OR, 1.58; 95% CrI, 1.19-2.04). The number of people with glaucoma worldwide will increase to 111.8 million in 2040, disproportionally affecting people residing in Asia and Africa. These estimates are important in guiding the designs of glaucoma screening, treatment, and related public health strategies. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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            Causes of vision loss worldwide, 1990-2010: a systematic analysis.

            Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking. We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990-2010 by age, geographical region, and year. In 2010, 65% (95% uncertainty interval [UI] 61-68) of 32·4 million blind people and 76% (73-79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65-70) of 31·8 million and 80% (78-83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration. The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care. Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute. Copyright © 2013 Bourne et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.
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              Glaucoma.

              Glaucoma is a heterogeneous group of diseases characterised by cupping of the optic nerve head and visual-field damage. It is the most frequent cause of irreversible blindness worldwide. Progression usually stops if the intraocular pressure is lowered by 30-50% from baseline. Its worldwide age-standardised prevalence in the population aged 40 years or older is about 3·5%. Chronic forms of glaucoma are painless and symptomatic visual-field defects occur late. Early detection by ophthalmological examination is mandatory. Risk factors for primary open-angle glaucoma-the most common form of glaucoma-include older age, elevated intraocular pressure, sub-Saharan African ethnic origin, positive family history, and high myopia. Older age, hyperopia, and east Asian ethnic origin are the main risk factors for primary angle-closure glaucoma. Glaucoma is diagnosed using ophthalmoscopy, tonometry, and perimetry. Treatment to lower intraocular pressure is based on topical drugs, laser therapy, and surgical intervention if other therapeutic modalities fail to prevent progression.
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                Author and article information

                Journal
                ORE
                Ophthalmic Res
                10.1159/issn.0030-3747
                Ophthalmic Research
                S. Karger AG
                0030-3747
                1423-0259
                2021
                March 2021
                30 July 2020
                : 64
                : 2
                : 310-320
                Affiliations
                Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China
                Author notes
                *Xu Zhang, Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of, Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, 463 Bayi Rd., Nanchang, Jiangxi 330006 (China), xuzhang19@163.com
                Article
                510572 Ophthalmic Res 2021;64:310–320
                10.1159/000510572
                32731219
                53f477b3-eabb-4ca9-9302-9025c61ee157
                © 2020 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 10 April 2020
                : 28 July 2020
                Page count
                Figures: 2, Tables: 4, Pages: 11
                Categories
                Research Article

                Vision sciences,Ophthalmology & Optometry,Pathology
                Ganglion cell-inner plexiform layer,Optic nerve head,Advanced glaucoma,Visual field,Associations

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