TY - JOUR
T1 - The rate of structural change
T2 - The confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study
AU - Zangwill, Linda M.
AU - Jain, Sonia
AU - Dirkes, Keri
AU - He, Feng
AU - Medeiros, Felipe A.
AU - Trick, Gary L.
AU - Brandt, James D.
AU - Cioffi, George A.
AU - Coleman, Anne L.
AU - Liebmann, Jeffrey M.
AU - Piltz-Seymour, Jody R.
AU - Gordon, Mae O.
AU - Kass, Michael A.
AU - Weinreb, Robert N.
N1 - Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest and the following were reported. Dr Zangwill receives instrument support from Carl Zeiss Meditec, Inc, Heidelberg Engineering, GmbH, Optovue, Inc, and Topcon Medical Systems, Inc. Dr Weinreb is a consultant for Alcon Laboratories, Inc, Allergan, Inc, and Carl Zeiss Meditec, Inc, and receives research support from Glaxo , Heidelberg Engineering , GmbH , Novartis , Optovue, Inc , Pfizer, Inc , and Topcon Medical Systems, Inc . Dr Trick is a consultant for Allergan, Inc. Dr Brandt is a consultant for Alcon Laboratories, Inc, Allergan, Inc, and Pfizer, Inc. Dr Cioffi is a consultant for Allergan, Inc, and Pfizer, Inc. Dr Liebmann is a consultant for Alcon Laboratories, Inc, Allergan, Inc, Diopsys, Inc, Optovue, Inc, Glaukos, Inc, Quark, Inc, and Merz Laboratories, Inc, and receives research support from Carl Zeiss Meditec, Inc , Diopsys, Inc , Optovue, Inc , Pfizer, Inc , Alcon Laboratories, Inc , Merck, Inc , Allergan, Inc , Topcon Medical Systems, Inc , and Glaukos, Inc . Dr Kass is a consultant for Pfizer, Inc. Publication of this article was supported by Grants EY11158 (R.N.W.) and EY09341 and EY09307 (M.O.G., M.A.K.), from the National Eye Institute, National Institutes of Health , Bethesda, Maryland and Vision Core Grant P30 EY02687 from the National Institutes of Health ; Horncrest Foundation Awards Ossining, New York; Merck Research Laboratories , White House Station, New Jersey; Pfizer, Inc , New York, New York; and unrestricted grants from the Research to Prevent Blindness, Inc , New York, New York. Involved in Design of study (M.O.G., M.A.K., L.M.Z., R.N.W.); Conduct of study (L.M.Z., K.D., J.D.B., G.A.C., A.L.C., J.M.L., J.R.P.-S., M.O.G., M.A.K., R.N.W.); Collection and management of data (L.M.Z., K.D., F.H., S.J., J.D.B., G.A.C., A.L.C., J.M.L., J.R.P.-S., M.O.G., M.A.K., R.N.W.); Analysis and interpretation of data (L.M.Z., S.J., F.H., J.D.B., G.A.C., A.L.C., J.M.L., J.R.P., M.O.G., M.A.K., R.N.W.); Preparation of manuscript (L.M.Z., S.J., F.H.); and Review or approval of manuscript (L.M.Z., K.D., J.D.B., G.A.C., A.L.C., J.M.L., J.R.P.-S., M.O.G., M.A.K., R.N.W.). Each of the coauthors has seen and agrees with each of the changes made to this manuscript in the revision and with the way his or her name is listed.
PY - 2013/6
Y1 - 2013/6
N2 - Purpose: To compare rates of topographic change in ocular hypertensive eyes that develop primary open-angle glaucoma (POAG) compared to eyes that do not, and to identify factors that influence the rate of change. Design: Longitudinal, randomized clinical trial. Methods: Four hundred forty-one participants (832 eyes) in the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study were included. POAG was defined as repeatable visual field, photography-based optic disc changes, or both. The rate of topographic change in the 52 participants (66 eyes) who developed POAG was compared with that of participants who did not develop POAG using multivariable mixed effects models. Results: In both univariate and multivariate analyses, the rate of rim area loss was significantly faster in eyes in which POAG developed than in eyes in which it did not (univariate mean, -0.0131 mm2/year and -0.0026 mm2/year, respectively). The significantly faster rate of rim area loss in black persons found in the univariate analysis did not remain significant when baseline disc area was included in the model. In multivariate analyses, the rate of rim area loss and other topographic parameters also was significantly faster in eyes with worse baseline visual field pattern standard deviation and higher intraocular pressure during follow-up. Moreover, a significant rate of rim area loss was detected in eyes in which POAG did not develop (P <.0001). The rate of rim area loss in eyes with an optic disc POAG endpoint was significantly faster than in those with a visual field POAG endpoint. Conclusions: The rate of rim area loss is approximately 5 times faster in eyes in which POAG developed compared with eyes in which it did not. These results suggest that measuring the rate of structural change can provide important information for the clinical management of ocular hypertensive patients. Additional follow-up is needed to determine whether the statistically significant change in the eyes in which POAG did not develop represents normal aging or glaucomatous change not detected by conventional methods.
AB - Purpose: To compare rates of topographic change in ocular hypertensive eyes that develop primary open-angle glaucoma (POAG) compared to eyes that do not, and to identify factors that influence the rate of change. Design: Longitudinal, randomized clinical trial. Methods: Four hundred forty-one participants (832 eyes) in the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study were included. POAG was defined as repeatable visual field, photography-based optic disc changes, or both. The rate of topographic change in the 52 participants (66 eyes) who developed POAG was compared with that of participants who did not develop POAG using multivariable mixed effects models. Results: In both univariate and multivariate analyses, the rate of rim area loss was significantly faster in eyes in which POAG developed than in eyes in which it did not (univariate mean, -0.0131 mm2/year and -0.0026 mm2/year, respectively). The significantly faster rate of rim area loss in black persons found in the univariate analysis did not remain significant when baseline disc area was included in the model. In multivariate analyses, the rate of rim area loss and other topographic parameters also was significantly faster in eyes with worse baseline visual field pattern standard deviation and higher intraocular pressure during follow-up. Moreover, a significant rate of rim area loss was detected in eyes in which POAG did not develop (P <.0001). The rate of rim area loss in eyes with an optic disc POAG endpoint was significantly faster than in those with a visual field POAG endpoint. Conclusions: The rate of rim area loss is approximately 5 times faster in eyes in which POAG developed compared with eyes in which it did not. These results suggest that measuring the rate of structural change can provide important information for the clinical management of ocular hypertensive patients. Additional follow-up is needed to determine whether the statistically significant change in the eyes in which POAG did not develop represents normal aging or glaucomatous change not detected by conventional methods.
UR - http://www.scopus.com/inward/record.url?scp=84877763209&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2013.01.020
DO - 10.1016/j.ajo.2013.01.020
M3 - Article
C2 - 23497845
AN - SCOPUS:84877763209
SN - 0002-9394
VL - 155
SP - 971
EP - 982
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 6
ER -