Progression of Local Glaucomatous Damage Near Fixation as Seen with Adaptive Optics Imaging.

Alfredo Dubra // Publications // Jul 01 2017

PubMed ID: 28713646

Author(s): Hood DC, Lee D, Jarukasetphon R, Nunez J, Mavrommatis MA, Rosen RB, Ritch R, Dubra A, Chui TYP. Progression of local glaucomatous damage near fixation as seen with adaptive optics imaging. Transl Vis Sci Technol. 2017 Jul 12;6(4):6. doi: 10.1167/tvst.6.4.6. eCollection 2017 Jul. PMID 28713646

Journal: Translational Vision Science & Technology, Volume 6, Issue 4, Jul 2017

PURPOSE Deep glaucomatous defects near fixation were followed over time with an adaptive optics-scanning light ophthalmoscope (AO-SLO) to better understand the progression of these defects and to explore the use of AO-SLO in detecting them.

METHODS Six eyes of 5 patients were imaged with an AO-SLO from 2 to 4 times for a range of 14.6 to 33.6 months. All eyes had open-angle glaucoma with deep defects in the superior visual field (VF) near fixation as defined by 10-2 VFs with 5 or more points less than -15 dB; two of the eyes had deep defects in the inferior VF as well. AO-SLO images were obtained around the temporal edge of the disc.

RESULTS In 4 of the 6 eyes, the edge of the inferior-temporal disc region of the retinal nerve fiber (RNF) defect seen on AO-SLO moved closer to fixation within 10.6 to 14.7 months. In 4 eyes, RNF bundles in the affected region appeared to lose contrast and/or disappear.

CONCLUSIONS Progressive changes in RNF bundles associated with deep defects on 10-2 VFs can be seen within about 1 year with AO-SLO imaging. These changes are well below the spatial resolution of the 10-2 VF. On the other hand, subtle thinning of regions with RNF bundles is not easy to see with current AO-SLO technology, and may be better followed with OCT.

TRANSLATIONAL RELEVANCE AO-SLO imaging may be useful in clinical trials designed to see very small changes in deep defects.