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POAG patients experience faster thinning of retinal nerve fiber layer

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DENVER – The retinal nerve fiber layer demonstrated more deterioration in eyes with primary open-angle glaucoma compared to normal eyes, according to a speaker here at the American Academy of Optometry meeting.

Given that published evidence describing longitudinal retinal nerve fiber layer (RNFL) change is currently limited, Sandra Ruezga, OD, and colleagues designed a study to investigate the rate of loss, she said.

Ruezga and colleagues conducted research based on the records of 100 subjects in an ongoing, prospective, longitudinal study.

The participants, 75 with primary open-angle glaucoma (POAG) and 35 with normal eyes, had at least three RNFL scans during a 2-year period, Ruezga said.

"There were more scans for POAGs in comparison to normals," she explained. "We follow our patients with POAG every 6 to 12 months vs. yearly for our normal patients."

Researchers analyzed mean change in global RNFL thickness per year, mean global RNFL values and RNFL thickness rate of change. Additionally, they measured visual field index slope and mean defect values, Ruezga said.

Results showed that the RNFL in the temporal, superior and inferior areas all significantly decreased over time for patients with POAG, she said. In contrast, only inferior RNFL showed significant thickness loss in normal eyes.

"Global as well as sectoral RNFL thickness deteriorated faster in POAG compared to normal eyes," Ruezga reported. "The highest rate of deterioration was found in the inferotemporal RNFL in both patients with POAG as well as the normal patients, which could have clinical implications.

"Baseline RNFL does impact the rate of RNFL change," she continued. "The higher the baseline, the higher the rate.”

Ruezga concluded: "When global RNFL loss exceeds 2.5 microns per year, and there's concurrent inter-eye asymmetry that's common in both global and sectoral RNFL, this asymmetry may suggest progression.” – by Chelsea Frajerman

Disclosure: The authors have no relevant financial disclosures.