Prevalence and OCT Characteristics of Glaucoma-Like Optic Neuropathy in a Real-World Population
Anna J. Sun, Emmanouil Tsamis, Tayna Gebhardt, Yujia Wang, Sol La Bruna, Christopher Lee, Mary K. Durbin, Donald C. HoodPrécis:
Based upon a real-world data set, the prevalence of subtle glaucoma-like defects in the macula is underestimated.
Purpose:
To understand the prevalence and characteristics of glaucoma-like defects in a large real-world data set using optical coherence tomography (OCT) and an OCT-based Reading Center (OCT-RC) approach.
Methods:
OCT scans were analyzed from 6184 individuals tested at optometric sites involved in refractive care. Based on commercial widefield OCT reports, foveal B-scans, and a previously published OCT-RC method, 361 individuals had evidence of optic neuropathy consistent with glaucoma in 1 or both eyes [ON-G (RC)]. Using the Columbia University (CU) OCT method, 2 experienced graders also labeled eyes as “ON-G (CU)” and “Not ON-G (CU),” based only upon the OCT report.
Results:
As expected, prevalence of pathology increased with age: 2.9% aged 50 years or older to 27.5% ≥70 years or older, with ON-G increasing from 2.1% (<50 y) to 14.2% (≥70 y). 320 (88.6%) of 361 ON-G eyes had macular damage, and 59 (16.3%) had thin arcuates largely restricted to the thick ganglion cell layer (GCL) region of the central macula. ON-G severity increased with age as indicated by central macular involvement. Using the CU method, 18% of ON-G individuals were judged as “Not ON-G (CU).”
Conclusions:
Glaucoma-like optic neuropathy was common in this real-world population and was characterized by frequent macular involvement, including early central GCL arcuate defects. These findings support the value of careful macular OCT assessment for identifying early glaucomatous structural damage.