Science has yet to figure out where all the pieces of the glaucoma puzzle fit but the primary goal has always been to preserve the patient’s vision. That requires, at the very least, early intervention. The sooner a clinician can determine glaucoma is present, the sooner they can initiate therapy. To that end, a top concern is evaluating the parapapillary and macular areas to observe structural damage at its earliest visible presentation.
Now, a research team out of Korea is attempting to evaluate whether it’s worthwhile to assess the progression in a serial analysis of combined widefield optical coherence tomography (OCT) maps that combine the two areas. Although the researchers note that more studies are necessary to confirm the results, the technique—which combines analysis of the retinal nerve fiber layer (RNFL) and the ganglion cell-inner plexiform layer (GCIPL)—fared well.
The study looked at 94 patients with early primary open-angle glaucoma who were imaged with stereo disc photography and red-free RNFL photography, Swedish interactive thresholding algorithm 30-2 perimetry and-OCT. Both eyes were imaged by OCT and examined by standard automated perimetry every six to 12 months for at least 36 months. The two structures showed good overall agreement in determining progression, the study shows. The researchers drew from this two primary conclusions.
“First, structural progression can be interpreted comprehensively in both the parapapillary and macular areas in one single image,” the report reads. “Second, various progression patterns of glaucomatous change can be observed and investigated,” the researchers added, going on to explain the various observed patterns of change and how they can be imaged using wide-field OCT technology. Although the study was relatively small, the report lends credence to the concept that combined widefield OCT maps can provide another method of early diagnosis and one more way to help preserve patients’ vision.
|Lee WJ, Kim TJ, Kim YK, et al. Serial combined wide-field optical coherence tomography maps for detection of early glaucomatous structural progression. JAMA Ophthalmol. July 26, 2018. [Epub ahead of print].