Earlier Detection of Glaucoma Progression Using High-Density 3-Dimensional Spectral-Domain OCT Optic Nerve Volume Scans

Kitiya Ratanawongphaibul, Edem Tsikata, Michele Zemplenyi, Hang Lee, Milica A. Margeta, Courtney L. Ondeck, Janice Kim, Billy X. Pan, Paul Petrakos, Anne L. Coleman, Fei Yu, Johannes F. de Boer, Teresa C. Chen*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Purpose: To compare onset times of glaucoma progression among different glaucoma tests: disc photography (DP), visual field (VF) testing, 2-dimensional (2D) retinal nerve fiber layer (RNFL) thickness, and 3-dimensional (3D) spectral-domain (SD) OCT neuroretinal rim measurements. Design: Prospective, longitudinal cohort study. Participants: One hundred twenty-four eyes of 124 patients with open-angle glaucoma. Methods: Over a 5-year period, 124 patients with open-angle glaucoma underwent yearly DP, VF testing, SD OCT RNFL thickness scans, and optic nerve volume scans (Spectralis; Heidelberg Engineering), all performed on the same day. From high-density optic nerve volume scans, custom-built software calculated the minimum distance band (MDB) thickness, a 3D neuroretinal rim parameter. Patients were classified as glaucoma progressors or nonglaucoma progressors using event-based analysis. Progression by DP and VF testing occurred when 3 masked glaucoma specialists unanimously concurred. Progression by RNFL and MDB thickness occurred if change of more than test–retest variability was observed. Kaplan-Meier curves were constructed to analyze time-to-progression data. Kappa Coefficients were used to measure agreement of progressing eyes among methods. Main Outcome Measures: Time to glaucoma progression among all 4 methods. Results: Global MDB thickness detected glaucoma progression in the highest percentage of eyes (52.4%) compared with DP (16.1%; P < 0.001) and global RNFL thickness (15.3%; P < 0.001). Global MDB thickness detected glaucoma progression earlier than either DP (23 months vs. 44 months; P < 0.001) or global RNFL thickness (23 months vs. 33 months; P < 0.001). Among MDB progressing eyes, 46.2% were confirmed simultaneously or later by other conventional methods. Agreement of glaucoma-progressing eyes for all 4 methods in paired fashion were slight to fair (κ = 0.095–0.300). Conclusions: High-density 3D SD OCT neuroretinal rim measurements detected glaucoma progression approximately 1 to 2 years earlier compared with current clinically available structural tests (i.e., DP and 2D RNFL thickness measurements).

Original languageEnglish
Pages (from-to)604-616
Number of pages13
JournalOphthalmology Glaucoma
Issue number6
Early online date25 Mar 2021
Publication statusPublished - Nov 2021

Bibliographical note

Funding Information:
Supported by the National Institutes of Health, Bethesda, Maryland (grant no.: UL1 RR 025758 [Harvard Catalyst Grant to T.C.C.]); Massachusetts Lions Eye Research Fund, New Bedford and Boston, Massachusetts (T.C.C.); American Glaucoma Society, San Francisco, California (Mid-Career Award [T.C.C.]); Fidelity Charitable Fund of Harvard University, Boston, Massachusetts (T.C.C.); the Department of Defense (Small Business Innovation Research award no.: DHP15-016 [T.C.C.]). The funding sources had no role in the study design or conduct of this research. J.F.dB.: Consultant ? UK-based law firm (expert testimony); Financial support ? TNO, Heidelberg Engineering, Dutch Science Foundation (NWO); Patent and Royalties ? Mass General Hospital, VU University. Obtained funding: Chen

Publisher Copyright:
© 2021 American Academy of Ophthalmology


  • Glaucoma progression
  • Neuroretinal rim
  • Optic nerve
  • Spectral-domain OCT
  • Volume scans


Dive into the research topics of 'Earlier Detection of Glaucoma Progression Using High-Density 3-Dimensional Spectral-Domain OCT Optic Nerve Volume Scans'. Together they form a unique fingerprint.

Cite this