Estimating the Rate of Retinal Ganglion Cell Loss in Glaucoma

Felipe A. Medeiros, Linda M. Zangwill, Douglas Anderson, Jeffrey M. Liebmann, Christopher A. Girkin, Ronald S. Harwerth, Marie Josée Fredette, Robert N. Weinreb

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Purpose: To present and evaluate a new method of estimating rates of retinal ganglion cell (RGC) loss in glaucoma by combining structural and functional measurements. Design: Observational cohort study. Methods: The study included 213 eyes of 213 glaucoma patients followed up for an average of 4.5 ± 0.8 years with standard automated perimetry visual fields and optical coherence tomography. A control group of 33 eyes of 33 glaucoma patients underwent repeated tests over a short period to test the specificity of the method. An additional group of 52 eyes from 52 healthy subjects followed up for an average of 4.0 ± 0.7 years was used to estimate age-related losses of RGCs. Estimates of RGC counts were obtained from standard automated perimetry and optical coherence tomography, and a weighted average was used to obtain a final estimate of the number of RGCs for each eye. The rate of RGC loss was calculated for each eye using linear regression. Progression was defined by a statistically significant slope faster than the age-expected loss of RGCs. Results: From the 213 eyes, 47 (22.1%) showed rates of RGC loss that were faster than the age-expected decline. A larger proportion of glaucomatous eyes showed progression based on rates of RGC loss rather than based on isolated parameters from standard automated perimetry (8.5%) or optical coherence tomography (14.6%; P < .01), while maintaining similar specificities in the stable group. Conclusions: The rate of RGC loss estimated from combining structure and function performed better than either isolated structural or functional measures for detecting progressive glaucomatous damage.

Original languageEnglish
JournalAmerican Journal of Ophthalmology
DOIs
StateAccepted/In press - Jul 30 2012

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Retinal Ganglion Cells
Glaucoma
Visual Field Tests
Optical Coherence Tomography
Visual Fields
Observational Studies
Linear Models
Healthy Volunteers
Cohort Studies
Cell Count
Control Groups

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Medeiros, F. A., Zangwill, L. M., Anderson, D., Liebmann, J. M., Girkin, C. A., Harwerth, R. S., ... Weinreb, R. N. (Accepted/In press). Estimating the Rate of Retinal Ganglion Cell Loss in Glaucoma. American Journal of Ophthalmology. https://doi.org/10.1016/j.ajo.2012.04.022

Estimating the Rate of Retinal Ganglion Cell Loss in Glaucoma. / Medeiros, Felipe A.; Zangwill, Linda M.; Anderson, Douglas; Liebmann, Jeffrey M.; Girkin, Christopher A.; Harwerth, Ronald S.; Fredette, Marie Josée; Weinreb, Robert N.

In: American Journal of Ophthalmology, 30.07.2012.

Research output: Contribution to journalArticle

Medeiros, FA, Zangwill, LM, Anderson, D, Liebmann, JM, Girkin, CA, Harwerth, RS, Fredette, MJ & Weinreb, RN 2012, 'Estimating the Rate of Retinal Ganglion Cell Loss in Glaucoma', American Journal of Ophthalmology. https://doi.org/10.1016/j.ajo.2012.04.022
Medeiros FA, Zangwill LM, Anderson D, Liebmann JM, Girkin CA, Harwerth RS et al. Estimating the Rate of Retinal Ganglion Cell Loss in Glaucoma. American Journal of Ophthalmology. 2012 Jul 30. https://doi.org/10.1016/j.ajo.2012.04.022
Medeiros, Felipe A. ; Zangwill, Linda M. ; Anderson, Douglas ; Liebmann, Jeffrey M. ; Girkin, Christopher A. ; Harwerth, Ronald S. ; Fredette, Marie Josée ; Weinreb, Robert N. / Estimating the Rate of Retinal Ganglion Cell Loss in Glaucoma. In: American Journal of Ophthalmology. 2012.
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