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Articles by R Ritch
Total Records ( 2 ) for R Ritch
  M Wang , D. C Hood , J. S Cho , Q Ghadiali , G. V De Moraes , X Zhang , R Ritch and J. M. Liebmann

Objective  To explore the feasibility of obtaining a local measurement of the thickness of the retinal ganglion cell layer in patients with glaucoma using frequency-domain optical coherence tomography (fdOCT) and a computer-aided manual segmentation procedure.

Methods  The fdOCT scans were obtained from the horizontal midline for 1 eye of 26 patients with glaucoma and 20 control subjects. The thickness of various layers was measured with a manual segmentation procedure aided by a computer program. The patients were divided into low- and high-sensitivity groups based on their foveal sensitivity on standard automated perimetry.

Results  The RGC plus inner plexiform and the retinal nerve fiber layers of the low-sensitivity group were significantly thinner than those of the high-sensitivity group. While these layers were thinner in the patients than the controls, the thicknesses of inner nuclear layer and receptor layer were similar in all 3 groups. Further, the thinning of the retinal ganglion cell plus inner plexiform layer in 1 glaucoma-affected eye showed qualitative correspondence to the loss in 10-2 visual field sensitivity.

Conclusions  Local measures of RGC layer thickness can be obtained from fdOCT scans using a manual segmentation procedure, and these measures show qualitative agreement with visual field sensitivity.

  C. G. V De Moraes , T. S Prata , C Tello , R Ritch and J. M. Liebmann

Objective  To evaluate whether damage to both hemifields in glaucomatous eyes predicts more rapid disease progression than does single-hemifield involvement.

Methods  We reviewed the medical records of 43 660 consecutive patients. Eyes with glaucomatous optic neuropathy, 10 or more Swedish Interactive Threshold Algorithm standard 24-2 visual fields in at least 5 years, and mean deviation (MD) smaller than –6.0 dB were included. Pointwise linear regression was used to determine progression. Cox proportional hazards analysis was used to calculate risk of progression based on different baseline covariates.

Results  We enrolled 205 eyes (205 patients; mean [SD] age, 64.2 [11.0] years; follow-up, 6.5 [1.8] years; number of visual fields, 12.3 [2.9]). Patients were divided into 3 groups: initial superior defect (group A; n = 79; MD, –3.4 [1.9] dB), initial inferior defect (group B; n = 61; MD, –3.4 [1.8] dB), and both hemifields affected (group C; n = 65; MD, –4.2 [1.5] dB). Group C progressed faster than did groups A and B (P < .02). Multivariate analysis showed significant effect of higher baseline intraocular pressure, thinner central corneal thickness, and initial damage to both hemifields.

Conclusions  Initial damage to both hemifields increases the risk of glaucoma progression. More aggressive therapy should be considered for these eyes.

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