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Baseline Topographic Optic Disc Measurements Are Associated With the Development of Primary Open-Angle Glaucoma
The Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study
Linda M. Zangwill, PhD;
Robert N. Weinreb, MD;
Julia A. Beiser, MS;
Charles C. Berry, PhD;
George A. Cioffi, MD;
Anne L. Coleman, MD, PhD;
Gary Trick, PhD;
Jeffrey M. Liebmann, MD;
James D. Brandt, MD;
Jody R. Piltz-Seymour, MD;
Keri A. Dirkes, MPH;
Suzanne Vega, MPH;
Michael A. Kass, MD;
Mae O. Gordon, PhD; for the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study Group
Arch Ophthalmol. 2005;123:1188-1197.
Objective To determine whether baseline confocal scanning laser ophthalmoscopy (CSLO) optic disc topographic measurements are associated with the development of primary open-angle glaucoma (POAG) in individuals with ocular hypertension.
Methods Eight hundred sixty-five eyes from 438 participants in the CSLO Ancillary Study to the Ocular Hypertension Treatment Study with good-quality baseline CSLO images were included in this study. Each baseline CSLO parameter was assessed in univariate and multivariate proportional hazards models to determine its association with the development of POAG.
Results Forty-one eyes from 36 CSLO Ancillary Study participants developed POAG. Several baseline topographic optic disc measurements were significantly associated with the development of POAG in both univariate and multivariate analyses, including larger cup-disc area ratio, mean cup depth, mean height contour, cup volume, reference plane height, and smaller rim area, rim area to disc area, and rim volume. In addition, classification as "outside normal limits" by the Heidelberg Retina Tomograph classification and the Moorfields Regression Analysis classifications (overall, global, temporal inferior, nasal inferior, and superior temporal regions) was significantly associated with the development of POAG. Within the follow-up period of this analysis, the positive predictive value of CSLO indexes ranged from 14% (Heidelberg Retina Tomograph classification and Moorfields Regression Analysis overall classification) to 40% for Moorfields Regression Analysis temporal superior classification.
Conclusions Several baseline topographic optic disc measurements alone or when combined with baseline clinical and demographic factors were significantly associated with the development of POAG among Ocular Hypertension Treatment Study participants. Longer follow-up is required to evaluate the true predictive accuracy of CSLO measures.
Author Affiliations: Hamilton Glaucoma Center and Diagnostic Imaging Laboratory, Department of Ophthalmology (Drs Zangwill and Weinreb, and Mss Dirkes and Vega), Family and Preventive Medicine (Dr Berry), University of California, San Diego, La Jolla; Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Mo (Ms Beiser and Drs Kass and Gordon); Devers Eye Institute, Portland, Ore (Dr Cioffi); Jules Stein Eye Institute, University of California, Los Angeles (Dr Coleman); Henry Ford Medical Center, Troy, Mich (Dr Trick); New York Eye and Ear Infirmary, New York (Dr Liebmann); Department of Ophthalmology, University of California, Davis, Sacramento (Dr Brandt); Scheie Eye Institute, University of Pennsylvania, Philadelphia (Dr Piltz-Seymour).
Group Information: For a complete list of group members, refer to the Ocular Hypertension Treatment Study Web site: https://vrcc.wustl.edu.
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