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Patterns of Glaucoma Progression in Combined Wide-field Optical Coherence Tomography Event-based Progression Analysis

Patterns of Glaucoma Progression in Combined Wide-field Optical Coherence Tomography Event-based Progression Analysis
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영상 조합을 통한 광범위 빛간섭단층촬영 이미지를 이용한 녹내장 구조적 진행의 패턴 분석
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Purpose: To investigate the spatial characteristics and patterns of structural progression using the combined retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) event-based progression analysis feature provided by the Guided Progression Analysis (GPA) software of spectral domain optical coherence tomography (SD-OCT). Methods: Retrospective observational study. Eighty nine patients with open angle glaucoma (OAG) showing clinically confirmed structural progression within a minimum follow up period of 3 years. For each eye, the RNFL and GCIPL GPA data were extracted from serial SD-OCT (HD-OCT 4000, Carl Zeiss Meditec, Inc.,Dublin, CA) data from 2012 to 2017. A combined wide-field GPA map was merged using vascular-landmark-guided superimposition of RNFL and GCIPL GPA event-based progression maps onto the RNFL image (resulting in the GPA PanoMaps). The pattern of progressive structural changes was evaluated by comparing the baseline combined wide-field OCT deviation maps (PanoMap deviation maps and GPA PanoMaps at the time the first progression was detected and the GPA PanoMaps at the last follow up. Spatial characteristics and patterns of glaucoma structural progression on GPA PanoMaps were evaluated. Results: Progressive structural progression was detected most frequently at the macular vulnerability zone, with the peripapillary and macular progression being well correlated spatially. Compared to the baseline structural change on PanoMap,the progressive structural changes extended toward the fovea at both, the peripapillary and macular areas. A spatial difference was observed between the areas where structural damage was frequently found on PanoMap and areas where progression was frequently found on GPA PanoMap. Conclusion: The patterns of progressive glaucomatous structural changes in both the peripapillary and macular areas were confirmed on the combined wide-field GPA map (GPA PanoMap). An analysis of the progression pattern using the GPA PanoMap facilitates the understanding of the spatial relation between the peripapillary and macular areas in glaucoma.
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GRADUATE SCHOOL[S](대학원) > MEDICINE(의학과) > Theses (Ph.D.)
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