Visual Field Progression Rate and Laminar Depth and Curvature in the African Descent and Glaucoma Evaluation Study (ADAGES)

Abstract

Abstract P urpose To determine if lamina cribrosa (LC) depth and curvature predict visual field (VF) progression rate in the African Descent and Glaucoma Evaluation Study (ADAGES) cohort in patients with primary open angle glaucoma (POAG). S ubjects Participants, and/or Controls. Three eyes from three research-consented brain-dead organ donors. M ethods Anterior laminar cribrosa surface depth (ALCSD) and LC curvature index (LCCI) were defined from 24 radial B-scan spectral domain optic coherence tomographic (SDOCT) images of each image. All scans were processed using a deep learning software to perform the segmentation and optic nerve health (ONH) layers. Univariable and multivariable linear mixed effects models were used to test associations between VF progression rate, ALCSD, and other demographic and clinical characteristics and known risk factors for progressive POAG. Additionally, the variable selection in the final multivariable model was reached using the Akaike information criterion index (AICc) and clinical utility. M easures IOP change with exposure to NP. M ain O utcome The associations between ALCSD and LCCI with the rate of VF progression. R esults There was a statistically significant relationship between faster VF progression rates, and a deeper ALCSD (−0.02 dB/year/50 microns, p<0.001) and LCCI (−0.01unit/dB/year, p<0.001). There was also increasing progression seen in both models for with increasing age (−0.025dB/year/10 years, p<0.007), intraocular pressure (IOP) (−0.011dB/year per 2 mmHg, p=0.021), and disease severity (0.017dB/year per dB, p<0.001). The rate of progression was faster in the ED cohort (−0.056 dB/year, p=0.006) following propensity matching for disease severity and age. C onclusions In the ADAGES cohort, there is a statistically significant association between VF progression rate and ALCSD and curvature (LCCI). A 50 um deeper LC at baseline had a similar effect of VF progression as being 10 years of age older. These data suggest that morphologic change in the ONH due to glaucomatous and age-related remodeling may induce greater vulnerability to develop progressive disease. Thus, LC depth and curvature may inform the likelihood and rate of glaucoma progression and are promising candidates for mechanistic biomarkers.