American researchers recently discovered both nerve fiber layer (NFL) focal loss measured by Fourier-domain optical coherence tomography (FD-OCT) and central corneal thickness are strong baseline predictors of the rate of glaucoma progression in patients with open-angle glaucoma.

This prospective, multicenter cohort study evaluated 150 eyes of 103 perimetric glaucoma patients of the Advanced Imaging for Glaucoma study who had completed nine visits. The researchers looked at predictive factors associated with confirmed rapid significant progression and slow progression using FD-OCT measurements of the optic disc, peripapillary retinal NFL and macular ganglion cell complex thicknesses.

The team observed slow progression in 80 eyes (53.3%) and rapid progression in 23 eyes (15.3%). They note that larger NFL and macular ganglion cell complex baseline focal loss volumes, thinner central corneal thickness and a lower visual field index were significant baseline predictors of more rapid progression.

The researchers add that the predictor with the highest odds ratio (OR) was NFL focal loss volume, which was also the most significant non-visual field predictor in multivariate analysis, as eyes with NFL-focal loss volume >8.5% had an OR of 2.67 for rapid significant progreession and 0.42 for slow progression.

Documenting FD-OCT and corneal biomechanical measurements may help clinicians better predict the rate of glaucoma progression, the study suggests.

Zhang X, Parrish II RK, Greenfield DS, et al. Predictive factors for the rate of visual field progression in the advanced imaging for glaucoma study. AM J Ophthalmol. February 20, 2019. [Epub ahead of print].