Patterns of Optical Coherence Tomography Imaging in Preperimetric Open Angle Glaucoma: A Comparative Study With Young-Age-Onset and Old-Age-Onset Eyes

Abstract

Précis: 

Optic coherence tomography imaging in preperimetric open angle glaucoma (OAG) differed between young-age-onset and old-age-onset eyes. Inferior and superior quadrants were thinner in young and old-age-onset eyes, respectively. Understanding the specific patterns of early glaucomatous damage based on age-at-onset may improve glaucoma diagnosis and monitoring.

Purpose: 

To investigate the patterns of retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thinning in preperimetric OAG by optical coherence tomography based on age at onset (“young-age onset (<40 y)” vs. “old-age onset (≥40 y)”.

Materials and Methods: 

The RNFL and GCIPL deviation images were acquired by Cirrus HD-optical coherence tomography, and overlaid, thus converted to a “deviation frequency map”, respectively. The topographic thinning patterns and parameters of RNFL and GCIPL thickness measurements were compared.

Results: 

A total of 194 eyes of 194 patients with preperimetric OAG and 97 eyes of 97 age-matched normal subjects were analyzed. Young-age-onset eyes of preperimetric OAG mainly had RNFL defects inferotemporally (264–296 degrees) with GCIPL defects in the inferior region (213–357 degrees). Old-age-onset preperimetric OAG eyes had RNFL defects inferotemporally (266–294°) and superotemporally (33–67 degrees), with GCIPL defects in the inferior and superior regions (206–360 degrees, 0–22 degrees). The inferior quadrant of RNFL and GCIPL thicknesses were significantly thinner in young-age-onset eyes compared with old-age-onset eyes (P=0.012, 0.016), while the superior quadrant of those were significantly thinner in the old-age-onset eyes (P=0.003, 0.005).

Conclusion: 

Young-age-onset and old-age-onset eyes of preperimetric OAG present different specific patterns of RNFL and GCIPL thinning.