Evaluation of Retinal Nerve Fiber Layer Thickness and Ganglion Cell Complex Progression Rates in Healthy, Ocular Hypertensive, and Glaucoma Eyes With the Avanti RTVue-XR Optical Coherence Tomograph Based on 5-Year Follow-up

Purpose: To determine retinal nerve fiber layer thickness (RNFLT) and ganglion cell complex (GCC) progression rates for healthy eyes and undertreatment ocular hypertensive (OHT) and glaucoma eyes with the Avanti RTVue-XR optical coherence tomography. Materials and Methods: Seventeen healthy subjects (34 eyes), 17 medically treated OHT patients (34 eyes), and 67 medically treated glaucoma patients (122 eyes) were imaged prospectively at 6-month intervals (median follow-up 5.3 y, 11 visits). Results: A minimal negative correlation between baseline RNFLT and RNFLT progression was found in the glaucoma group ( r =−0.1708, P =0.0493). In the other groups no correlation between baseline RNFLT or GCC and RNFLT or GCC progression was found, respectively. The mean±SD of the rate of change was −0.33±0.51, −0.44±0.62, and −0.69±0.93 μm/y for average RNFLT, and −0.53±0.36, −0.54±0.52, and −0.80±0.78 for average GCC, for the normal, OHT, and glaucoma eyes, respectively ( P >0.05 for all between-group comparisons). In the normal group the highest progression rate was −1.52 μm/y for average RNFLT and −1.28 μm/y for average GCC. Despite maximal medical treatment, progression in the glaucoma group exceeded the highest progression rate of the normal group in 18 eyes (14.8%) for average RNFLT and 24 eyes (19.7%) for average GCC. Conclusions: We determined progression rates for untreated healthy and under treatment OHT and glaucoma eyes with the Avanti RTVue-XR optical coherence tomography. We found that an average RNFLT progression rate faster than −1.5 μm/y, and an average GCC progression rate faster than −1.3 μm/y are strongly suggestive for uncontrolled glaucomatous progression. Detection of uncontrolled structural progression with trend analysis may assist the early detection of fast progressors.