• Can OCT Be Used to Evaluate Advanced Glaucoma?

    By Jean Shaw
    Selected By: Henry D. Jampel, MD, MHS

    Journal Highlights

    Ophthalmology Glaucoma, May/June 2019

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    The common assumption is that optical coherence tomography (OCT) cannot be used to monitor eyes with advanced glaucoma. Lee et al. set out to examine the validity of this assumption by exploring the hypothesis that if eyes with advanced glaucoma have a 10-2 total deviation map with any points better than –8 dB, then the topograph­ically corresponding regions on the circumpapillary retinal nerve fiber layer (cpRNFL) should show a preserved region. They found evidence to support this hypothesis and concluded that OCT scanning can be used to follow these preserved regions.

    For this retrospective study, the re­searchers examined the cpRNFL scans of 39 eyes (33 patients). All eyes had a 24-2 visual field (VF) with a mean deviation (MD) of –15 dB or worse (mean, –18.94 ± 2.95 dB; range, –27.06 to –15.01 dB). 10-2 VFs and averaged OCT circle scans were available for all eyes. (The circle scans were acquired in a high-speed mode and set to average 100 times.)

    When the circle scans were inspect­ed, all 39 eyes showed a recognizable cpRNFL in the region associated with the macula. In 36 of the eyes, the cpRNFL region was clear and hyper­dense. The other three eyes demon­strated visible cpRNFL, but it was of low contrast.

    The authors cautioned that this study has several limitations, including a small sample size and the study’s retrospective nature. In addition, they said, the assessment of cpRNFL was qualitative. As a result, they called for a prospective study of eyes that have advanced glaucoma defined by a 24-2 VF MD worse than –15 dB, quantitative cpRNFL measurements, or both.

    The original article can be found here.