Abstract：
OBJECTIVE: To investigate glaucoma progression based on Optical Coherence Tomography (OCT) Guided Progression Analysis (GPA) according to baseline β-zone parapapillary atrophy (PPA) morphology in glaucoma patients.
METHODS: Retrospective cohort study.
METHODS: Patients over 20 years of age who had been diagnosed with primary open-angle glaucoma (POAG) at Seoul National University Hospital, Seoul, Korea between 2010 and 2020. This study included POAG patients with a minimum of 5 years of follow-up. We quantitatively measured the baseline β-zone PPA parameters, classified β-zone PPA morphology according to new classification standard we created and analyzed the corresponding GPA progression of the retinal nerve fiber layer (RNFL).
RESULTS: A total of 210 patients with POAG (mean age: 53.8 years) were enrolled in the study. The mean follow-up period was 9.8 years. The average value of the baseline mean deviation in visual field perimetry was -2.48 dB. Longer radial extent and larger angular extent of β-zone PPA were significantly associated with progression on GPA, as was the presence of disk hemorrhage. Among the 4 classified β-zone PPA morphologies (Crescent type 1 & 2, Solar-eclipse type 1 & 2), the Solar-eclipse type 2 group showed the highest progression. A Kaplan-Meier survival analysis demonstrated significant differences among the 4 types.
CONCLUSIONS: The larger the radial and angular extents of β-zone PPA, the more progression that was shown on OCT GPA. Furthermore, significant differences in progression were noted based on the morphological type of β-zone PPA. Our findings indicate that baseline β-zone PPA parameters and morphology are valuable predictors of future glaucoma progression.
METHODS: Retrospective cohort study.
METHODS: Patients over 20 years of age who had been diagnosed with primary open-angle glaucoma (POAG) at Seoul National University Hospital, Seoul, Korea between 2010 and 2020. This study included POAG patients with a minimum of 5 years of follow-up. We quantitatively measured the baseline β-zone PPA parameters, classified β-zone PPA morphology according to new classification standard we created and analyzed the corresponding GPA progression of the retinal nerve fiber layer (RNFL).
RESULTS: A total of 210 patients with POAG (mean age: 53.8 years) were enrolled in the study. The mean follow-up period was 9.8 years. The average value of the baseline mean deviation in visual field perimetry was -2.48 dB. Longer radial extent and larger angular extent of β-zone PPA were significantly associated with progression on GPA, as was the presence of disk hemorrhage. Among the 4 classified β-zone PPA morphologies (Crescent type 1 & 2, Solar-eclipse type 1 & 2), the Solar-eclipse type 2 group showed the highest progression. A Kaplan-Meier survival analysis demonstrated significant differences among the 4 types.
CONCLUSIONS: The larger the radial and angular extents of β-zone PPA, the more progression that was shown on OCT GPA. Furthermore, significant differences in progression were noted based on the morphological type of β-zone PPA. Our findings indicate that baseline β-zone PPA parameters and morphology are valuable predictors of future glaucoma progression.
摘要：
目的：根据基线β区乳头旁萎缩（PPA）形态，基于光学相干断层扫描（OCT）引导的进展分析（GPA）研究青光眼的进展。
方法：回顾性队列研究。
方法：在首尔国立大学医院诊断为原发性开角型青光眼（POAG）的20岁以上患者，首尔,2010年至2020年，韩国。这项研究包括POAG患者至少5年的随访。我们定量测量了基线β区PPA参数，根据我们创建的新分类标准对β区PPA形态进行分类，并分析了视网膜神经纤维层（RNFL）的相应GPA进展。
结果：共有210名POAG患者（平均年龄：53.8岁）被纳入研究。平均随访期为9.8年。视野检查中基线平均偏差的平均值为-2.48dB。β区PPA的较长的径向范围和较大的角度范围与GPA的进展显着相关，椎间盘出血的存在也是如此。在4种分类的β区PPA形态（新月型1和2，日食型1和2）中，日食2型组表现出最高的进展。Kaplan-Meier生存分析显示4种类型之间存在显著差异。
结论：β区PPA的径向和角度范围越大，OCTGPA显示的进展越多。此外，根据β区PPA的形态类型，发现进展存在显着差异。我们的发现表明，基线β区PPA参数和形态学是未来青光眼进展的有价值的预测因子。
方法：回顾性队列研究。
方法：在首尔国立大学医院诊断为原发性开角型青光眼（POAG）的20岁以上患者，首尔,2010年至2020年，韩国。这项研究包括POAG患者至少5年的随访。我们定量测量了基线β区PPA参数，根据我们创建的新分类标准对β区PPA形态进行分类，并分析了视网膜神经纤维层（RNFL）的相应GPA进展。
结果：共有210名POAG患者（平均年龄：53.8岁）被纳入研究。平均随访期为9.8年。视野检查中基线平均偏差的平均值为-2.48dB。β区PPA的较长的径向范围和较大的角度范围与GPA的进展显着相关，椎间盘出血的存在也是如此。在4种分类的β区PPA形态（新月型1和2，日食型1和2）中，日食2型组表现出最高的进展。Kaplan-Meier生存分析显示4种类型之间存在显著差异。
结论：β区PPA的径向和角度范围越大，OCTGPA显示的进展越多。此外，根据β区PPA的形态类型，发现进展存在显着差异。我们的发现表明，基线β区PPA参数和形态学是未来青光眼进展的有价值的预测因子。
