Can Macula and Optic Nerve Head Parameters Detect Glaucoma Progression in Eyes with Advanced Circumpapillary Retinal Nerve Fiber Layer Damage

Purpose To evaluate the ability of OCT optic nerve head (ONH) and macular parameters to detect disease progression in eyes with advanced structural glaucomatous damage of the circumpapillary retinal nerve fiber layer (cRNFL). Design Longitudinal study. Participants Forty-four eyes from 37 patients with advanced average cRNFL damage (≤60 μm) followed up for an average of 4.0 years. Methods All patients were examined with spectral-domain OCT and visual field (VF) assessment during at least 4 visits. Main Outcome Measurements Visual field mean deviation (MD) and VF index. OCT cRNFL (average, superior, and inferior quadrants), ganglion cell–inner plexiform layer (GCIPL) (average, superior, and inferior), rim area, cup volume, average cup-to-disc (C:D) ratio, and vertical C:D ratio. Results At baseline, patients had a median VF MD of –10.18 dB and mean cRNFL of 54.55±3.42 μm. The rate of change for MD and VF index were significant. No significant rate of change was noted for cRNFL, whereas significant ( P 2 /year). Conclusions Macula GCIPL and ONH parameters may be useful in tracking progression in patients with advanced glaucoma.