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Donald C. Hood, Dongwon Lee, Ravivarn Jarukasetphon, Jason Nunez, Maria A. Mavrommatis, Richard B. Rosen, Robert Ritch, Alfredo Dubra, Toco Y. P. Chui; Progression of Local Glaucomatous Damage Near Fixation as Seen with Adaptive Optics Imaging. Trans. Vis. Sci. Tech. 2017;6(4):6. doi: https://doi.org/10.1167/tvst.6.4.6.
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Deep glaucomatous defects near fixation were followed over time with an adaptive optics-scanning light ophthalmoscope (AO-SLO) to better understand the progression of these defects and to explore the use of AO-SLO in detecting them.
Six eyes of 5 patients were imaged with an AO-SLO from 2 to 4 times for a range of 14.6 to 33.6 months. All eyes had open-angle glaucoma with deep defects in the superior visual field (VF) near fixation as defined by 10-2 VFs with 5 or more points less than −15 dB; two of the eyes had deep defects in the inferior VF as well. AO-SLO images were obtained around the temporal edge of the disc.
In 4 of the 6 eyes, the edge of the inferior-temporal disc region of the retinal nerve fiber (RNF) defect seen on AO-SLO moved closer to fixation within 10.6 to 14.7 months. In 4 eyes, RNF bundles in the affected region appeared to lose contrast and/or disappear.
Progressive changes in RNF bundles associated with deep defects on 10-2 VFs can be seen within about 1 year with AO-SLO imaging. These changes are well below the spatial resolution of the 10-2 VF. On the other hand, subtle thinning of regions with RNF bundles is not easy to see with current AO-SLO technology, and may be better followed with OCT.
AO-SLO imaging may be useful in clinical trials designed to see very small changes in deep defects.
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