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dc.contributor.authorMarshall, Henryen_US
dc.contributor.authorAndrew, Nicholas Hen_US
dc.contributor.authorHassall, Marken_US
dc.contributor.authorQassim, Ayuben_US
dc.contributor.authorSouzeau, Emmanuelleen_US
dc.contributor.authorRidge, Bronwynen_US
dc.contributor.authorNguyen, Thien_US
dc.contributor.authorFitzgerald, Jude Ten_US
dc.contributor.authorAwadalla, Mona Sen_US
dc.contributor.authorBurdon, Kathryn Penelopeen_US
dc.contributor.authorHealey, Paul Ren_US
dc.contributor.authorAgar, Ashishen_US
dc.contributor.authorGalanopoulos, Annaen_US
dc.contributor.authorHewitt, Alex Wen_US
dc.contributor.authorGraham, Stuart Len_US
dc.contributor.authorLanders, Johnen_US
dc.contributor.authorCasson, Robert Jen_US
dc.contributor.authorCraig, Jamie Een_US
dc.date.accessioned2019-04-02T04:10:06Z
dc.date.available2019-04-02T04:10:06Z
dc.date.issued2019-03-22
dc.identifier.citationMarshall HN, Andrew NH, Hassall M, Qassim A, Souzeau E, Ridge B, Nguyen T, Fitzgerald J, Awadalla MS, Burdon KP, Healey PR, Agar, Galanopoulos A, Hewitt AW, Graham SL, Landers J, Casson RJ, Craig JE, Macular GCIPL loss precedes peripapillary RNFL loss in glaucoma with lower intraocular pressure, Ophthalmology (2019), https://doi.org/10.1016/j.ophtha.2019.03.016en_US
dc.identifier.issn0161-6420
dc.identifier.urihttp://hdl.handle.net/2328/39110
dc.description© 2019 by the American Academy of Ophthalmology. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (March 2019) in accordance with the publisher’s archiving policyen_US
dc.description.abstractPurpose To investigate which clinical measures influence whether an individual demonstrates earliest glaucomatous structural progression on peripapillary retinal nerve fibre layer (pRNFL) or macular ganglion cell-inner plexiform layer (mGCIPL). Design Prospective longitudinal cohort study. Participants 271 eyes from 207 individuals with statistically significant evidence of glaucomatous progression on optical coherence tomography (OCT)-Guided Progression Analysis (GPA) software were drawn from a total of 1271 eyes from 686 individuals categorized as glaucoma suspect or having early manifest glaucoma undergoing glaucoma surveillance. Methods Individuals demonstrating earliest evidence of longitudinal progression on mGCIPL GPA event analysis were compared to individuals demonstrating evidence of earliest longitudinal progression on pRNFL GPA event analysis. Outcome Measures Correlation of OCT event change analysis with intraocular pressure (IOP), clinical variables, and baseline thickness of the pRNFL and mGCIPL. Results IOP, baseline pRNFL thickness, baseline mGCIPL thickness and systemic hypertension were associated with location of first progression. Eyes demonstrating earliest longitudinal progression on mGCIPL had significantly lower maximum-recorded pre-treatment IOP (mean difference: 3.90mmHg, 95%CI: 2.37-5.43; p<0.001). The time interval between progression on pRNFL and progression on mGCIPL increased by 12.4 months for every 5mmHg increase in IOP (95%CI: 10.32 -15.72). Eyes demonstrating earliest longitudinal progression on mGCIPL had significantly lower baseline average pRNFL thickness than eyes progressing on pRNFL first (mean difference: 7.07μm; 95%CI: 4-38-9.77; p<0.001). Eyes progressing first on mGCIPL parameters were 3.03 times more likely to develop a new paracentral field defect than cases progressing first on pRNFL parameters (OR: 3.03; 95%CI: 1.26-7.28; p=0.01). Conclusion Clinical features, particularly pre-treatment IOP, influence whether structural glaucoma progression is detected earlier with mGCIPL or pRNFL imaging. These data support the utility of mGCIPL imaging in addition to pRNFL analysis for detection of glaucoma progression, particularly in patients with normal IOP.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relationhttp://purl.org/au-research/grants/nhmrc/1048037en_US
dc.rights© 2019 by the American Academy of Ophthalmology.en_US
dc.subjectMacular GCIPLen_US
dc.subjectglaucomaen_US
dc.subjectintraocular pressureen_US
dc.subjecteyesen_US
dc.titleMacular GCIPL loss precedes peripapillary RNFL loss in glaucoma with lower intraocular pressureen_US
dc.typeArticleen_US
dc.relation.grantnumberNHMRC/1048037en_US
dc.identifier.doihttps://doi.org/10.1016/j.ophtha.2019.03.016en_US
dc.rights.holderAmerican Academy of Ophthalmology.en_US
local.contributor.authorOrcidLookupMarshall, Henry: https://orcid.org/0000-0002-4425-2272en_US
local.contributor.authorOrcidLookupSouzeau, Emmanuelle: https://orcid.org/0000-0002-2015-6577en_US
local.contributor.authorOrcidLookupCraig, Jamie E: https://orcid.org/0000-0001-9955-9696en_US
local.contributor.authorOrcidLookupAwadalla, Mona S: https://orcid.org/0000-0002-7758-7669en_US
local.contributor.authorOrcidLookupHassall, Mark: https://orcid.org/0000-0002-6180-7954en_US


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