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Nerve Fiber Layer Thickness and Characteristics Associated with Glaucoma in Community Living Older Adults: Prelude to a Screening Trial?
Journal article   Open access   Peer reviewed

Nerve Fiber Layer Thickness and Characteristics Associated with Glaucoma in Community Living Older Adults: Prelude to a Screening Trial?

Barbara E. K Klein, Chris A Johnson, Stacy M Meuer, Kyungmoo Lee, Andreas Wahle, Kristine E Lee, Amruta Kulkarni, Milan Sonka, Michael D Abràmoff and Ronald Klein
Ophthalmic Epidemiology, Vol.24(2), pp.104-110
03/04/2017
DOI: 10.1080/09286586.2016.1258082
PMCID: PMC5624712
PMID: 28032805
url
http://doi.org/10.1080/09286586.2016.1258082View
Open Access

Abstract

Purpose: To examine the associations of nerve fiber layer (NFL) thickness with other ocular characteristics in older adults. Methods: Participants in the Beaver Dam Eye Study (2008-2010) underwent spectral domain optical coherence tomography (SD-OCT) scans of the optic nerve head, imaging of optic discs, frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP), and an interview concerning their history of glaucoma and use of drops to lower eye pressure. Self-reported histories of glaucoma and the use of drops to lower eye pressure were obtained at follow-up examinations (2014-2016). Results: NFL thickness measured on OCTs varied by location around the optic nerve. Age was associated with mean NFL thickness. Mean NFL was thinnest in eyes with larger cup/disc (C/D) ratios. Horizontal hemifield defects or other optic nerve-field defects were associated with thinner NFL. NFL in persons who reported taking eye drops for high intraocular pressure was thinner compared to those not taking drops. After accounting for the presence of high intraocular pressure, large C/D ratios or hemifield defects, eyes with thinner NFL in the arcades were more likely (OR = 2.3 for 30 micron thinner NFL, p = 0.04) to have incident glaucoma at examination 5 years later. Conclusion: Retinal NFL thickness was associated with a new history of self-reported glaucoma 5 years later. A trial testing the usefulness of NFL as part of a screening battery for predicting glaucoma in those previously undiagnosed might lead to improved case finding and, ultimately, to diminishing the risk of visual field loss.
Frequency doubling technology visual field spectral domain optical coherence tomography glaucoma nerve fiber layer

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