To compare rates of change (RoC) of peripapillary retinal nerve fiber layer (RNFL) and Bruch’s membrane opening-based minimum rim width (BMO-MRW) thickness in moderate-to- advanced glaucoma DESIGN: Prospective cohort study.
Longitudinal optical coherence tomography (OCT) optic nerve head volume scans of 113 eyes of 113 glaucoma patients with moderate-to-advanced or central damage were exported. We estimated and compared global and sectoral RoC with linear mixed effects models (LMM) and simple linear regression (SLR) of RNFL and BMO-MRW thickness. Permutation analyses were used to test significance of RoC in the SLR model. We also compared longitudinal signal-to-noise ratios (LSNR) defined as RoC divided by residual SD between the two groups.
Mean (SD) follow-up and median (IQR) OCT scan sessions were 5.2 (1.3) years and 10 (8-11), respectively. Baseline average (SD) visual field mean deviation was -9.2 (5.8) dB. Based on SLR, a higher proportion of significant negative RNFL RoC was observed compared to BMO-MRW in the inferotemporal (35% vs. 20%; p=0.015) and inferonasal (42% vs. 17%; p<0.001) sectors. Permutation analyses also demonstrated a higher proportion of worsening RNFL RoC than BMO-MRW in the inferotemporal (p=0.026) and inferonasal (p<0.001) sectors along with overall lower positive RoC. LSNR for RNFL was significantly more negative than that of BMO-MRW globally, and in the inferotemporal, inferonasal, and superonasal sectors (p≤0.01).
Longitudinal RNFL OCT measurements are more likely to detect structural change and demonstrate higher SNR compared to BMO-MRW in eyes with central or moderate to advanced glaucoma damage at baseline.

Copyright © 2023. Published by Elsevier Inc.