Effects of Optic Nerve Head Structures on Retinal Nerve Fiber Layer Defects in Primary Open Angle Glaucoma Eyes: Analyses Using Retinal Optical Texture Analysis - 05/05/26

Doi : 10.1016/j.ajo.2026.01.035

Atsuya Miki ^a,^b,^⁎ , Makoto Araie ^c, Christopher Kai Shun Leung ^d, Masashi Nishigaki ^a, Hiroshi Murata ^e, Tsutomu Kikawa ^f, Kazuhisa Sugiyama ^g, Tomomi Higashide ^g, Hitomi Saito ^h, Makoto Aihara ^h, Aiko Iwase ⁱ, Goji Tomita ^j, Toru Nakazawa ^k, Kyoko Ohno-Matsui ^l, Tae-Woo Kim ^m, Linda M. Zangwill ⁿ, Robert N. Weinreb ⁿ

^a From the Department of Ophthalmology, Aichi Medical University School of Medicine (A.M., M.N.), Aichi, Japan

^b Department of Myopia Control Research, Aichi Medical University School of Medicine (A.M.), Aichi, Japan

^c Kanto Central Hospital of the Mutual Aid Association of Public School Teachers (M.Ar.), Tokyo, Japan

^d Department of Ophthalmology, LKS Faculty of Medicine, the University of Hong Kong (C.K.S.L.), Hong Kong Special Administrative Region, China

^e Department of Ophthalmology, Toranomon Hospital (H.M.), Tokyo, Japan

^f R&D Division, Topcon Corporation (T.K.), Tokyo, Japan

^g Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences (K.S., T.H.), Kanazawa, Japan

^h Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo (H.S., M.Ai.), Tokyo,Japan

ⁱ Tajimi Iwase Eye Clinic (A.I.), Tajimi, Japan

^j Department of Ophthalmology, Toho University Ohashi Medical Center (G.T.), Tokyo, Japan

^k Department of Ophthalmology, Graduate School of Medicine, Tohoku University (T.N.), Sendai, Japan

^l Department of Ophthalmology and Visual Science, Institute of Science Tokyo (K.O.-M.), Tokyo, Japan

^m Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital (T.-W.K.), Seongnam, Korea

ⁿ Hamilton Glaucoma Center, Shiley Eye Institute, and the Viterbi Family Department of Ophthalmology, University of California San Diego (L.M.Z., R.N.W.), La Jolla, California, USA.

^⁎ Inquiries to Atsuya Miki, Department of Myopia Control Research, Aichi Medical University Medical School, Nagakute, Aichi, Japan Department of Myopia Control Research Aichi Medical University Medical School Nagakute Aichi Japan

Résumé

Purpose

To elucidate associations between optic nerve head (ONH) structures and the retinal nerve fiber layer optical texture analysis (ROTA)–detected retinal nerve fiber layer defects (RNFLDs) in primary open angle glaucoma (POAG) eyes.

Design

Prospective cross-sectional observational study.

Participants

This study enrolled 136 eyes of 109 POAG patients.

Methods

All participants underwent comprehensive ophthalmologic examinations including standard automated perimetry and swept-source optical coherence tomography (SS-OCT). Two independent graders assessed ROTA images for the presence, location, and width of RNFLDs. Multivariable linear mixed effects model was used to investigate factors independently associated with ROTA-detected RNFLDs. Explanatory variables were systemic and ocular factors such as age, axial length (AXL), SS-OCT-derived ONH structural parameters such as Bruch membrane opening-centered circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and gamma zone area, and average visual field sensitivity (1/Lambert) (VFS _average ).

Main Outcome Measures

Width and number of RNFLDs.

Results

RNFLD detection rates by ROTA were 86.8% overall, 69.0% and 94.7% in the early and moderate stages of POAG eyes, and 86.5% and 87.2% in the highly myopic (AXL > 26.0 mm) and non–highly myopic eyes, respectively. Summed width of RNFLD per eye was positively correlated with gamma-zone area ( P = .0007) and negatively correlated with age, cpRNFLT, and VFS _average ( P = .0111, .0001, .0124), whereas the number of RNFLDs per eye correlated negatively with age, cpRNFLT, and VFS _average ( P = .0153, .0029, .0007).

Conclusions

The ROTA-detected extent of axonal damage was associated with ONH structural change represented by gamma zone area in POAG eyes after adjustment for other possible confounding factors.

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Plan

METHODS

DESIGN

IDENTIFICATION AND MEASUREMENT OF RNFL DEFECTS ON THE ROTA IMAGES

MEASUREMENTS OF THE OPTIC NERVE HEAD PARAMETERS

STATISTICAL ANALYSIS

RESULTS

DISCUSSION

CRediT authorship contribution statement

Supplemental Material available at AJO.com .

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Vol 286

P. 123-131 - juin 2026 Retour au numéro

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Effects of Optic Nerve Head Structures on Retinal Nerve Fiber Layer Defects in Primary Open Angle Glaucoma Eyes: Analyses Using Retinal Optical Texture Analysis - 05/05/26

Résumé

Purpose

Design

Participants

Methods

Main Outcome Measures

Results

Conclusions

Plan

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