Intereye Spatial Relationship of Abnormal Neuroretinal Rim Locations in Glaucoma Patients from the Diagnostic Innovations in Glaucoma Study

Purpose To determine the spatial relationship in neuroretinal rim parameter values between eyes in ocular hypertensives, glaucoma suspects, and glaucoma patients. Design Observational-cross-sectional study. Methods A total of 334 eyes of 167 patients were included. All patients underwent confocal scanning laser ophthalmoscopy imaging in both eyes. Intereye concordance ratio of abnormal rim sectors as classified by the Moorfield regression analysis (MRA) was calculated as the ratio of matching abnormal rim areas to the total number of abnormal rim areas. The amount of agreement was calculated for each sector separately. Results Of the right (left) eyes, 39 (39) eyes were classified “borderline” (BL) by MRA, 62 (65) eyes were “within normal limits” (WNL), and 66 (63) eyes “outside normal limits” (ONL). A total of 78 patients had a normal overall MRA result in both eyes (BL = WNL). Of the 89 patients with a defect in at least one sector, mean intereye concordance was 0.28 ± 0.04 (BL = WNL). When considering BL as ONL, concordance increased to 0.43 ± 0.03. The lowest intereye agreement in rim abnormality was found in the temporal-inferior sector with 29.0% (Kappa ± SE [standard error], 0.25 ± 0.09, BL = WNL) matching. The highest agreement was found in the nasal- inferior sector with 47% (Kappa ± SE, 0.53 ± 0.1, BL = WNL) matching. Conclusions There is a moderate intereye agreement in abnormal neuroretinal rim locations in eyes of ocular hypertensives, glaucoma suspects, and glaucoma patients. Longitudinal studies are needed to elucidate the agreement over time and to better understand the morphological pattern of progression between eyes in glaucoma.