Rapid initial OCT RNFL thinning is predictive of faster visu
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The aim of this study was to see a connection between the rate of retinal nerve fiber layer (RNFL) loss during initial follow-up and the magnitude of associated visual field loss over time.

A total of 1,150 eyes of 839 glaucoma patients were extracted from the Duke Glaucoma Registry. Rates of RNFL loss were obtained from global RNFL thickness values of the first 5 optical coherence tomography (OCT) scans. Rates of visual field loss were assessed using standard automated perimetry mean deviation (SAP MD) during the entire follow-up period. Joint longitudinal mixed effects models were used to estimate rates of change. Eyes were categorized as fast, moderate or slow progressors based on rates of RNFL loss, with cutoffs of less than -2 microm/year, -2 to -1 microm/year and more than -1 microm/year, respectively. Univariable and multivariable regressions were completed to identify significant predictors of SAP MD loss.

Results:
--The rate of RNFL change was -0.76±0.85 microm/y during initial follow-up, which occurred over 3.7±1.5 years.

--765 eyes were slow, 328 moderate, and 57 fast progressors, with rates of RNFL thinning of -0.36±0.54 microm/year, -1.34±0.25 microm/year, and -2.87±1.39 microm/year respectively.

--The rates of SAP MD loss among slow, moderate, and fast OCT progressors were -0.16±0.35 dB/y, -0.32±0.43 dB/y, and -0.71±0.65 dB/y respectively over the extended follow-up period of 6.1±1.9 years.

--Age, OCT progressor group, and concurrent SAP rate were all significantly associated with the overall rate of SAP MD loss in a multivariable model.

Finally, rapid RNFL thinning during the initial follow-up period was linked to concurrent and subsequent rates of visual field decline over time.

Source: https://www.ajo.com/article/S0002-9394(21)00132-X/fulltext?rss=yes
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