Progressive thickening of retinal nerve fiber and ganglion cell complex layers following SDM Vision Protection Therapy for Open Angle Glaucoma: Evidence of Therapeutic Retinal (CNS) Neuroregeneration

Abstract

Purpose To determine the effect on nerve fiber layer (NFL) and ganglion cell complex (GCC) thickness trends in eyes with open angle glaucoma (OAG) treated with Vision Protection Therapy™ (VPT). Background Progressive thinning of the NFL and GCC in OAG is the rule. Method A retrospective analysis of spectral-domain optical coherence tomography (OCT) measured NFL and GCC thickness trends was performed, excluding eyes with poor quality scans and principal diagnoses other than OAG. This study compares eyes with OAG managed conventionally with IOP control alone (controls), to eyes managed with the addition of VPT (VPT eyes). The direction (+ or - ) and magnitude (microns/year) of the OCT trends were the study endpoints. Results: 78 control eyes of 40 patients (avg age 73 years) and 61 VPT eyes of 39 patients (avg age 78 years) were included for study. Mean observation periods (days) were 708 for controls and 730 for VPT. Positive NFL trends were noted in 5% of control eyes vs 71% of VPT eyes (p < 0.0001). Positive GCC trends were noted in 8% of control eyes vs 43% of VPT eyes (p < 0.0001). Mean NFL trends (um/year) were − 0.692 for controls vs + 0.347 for VPT (p < 0.0001). Mean GCC trends (um/year) were − 0.554 for controls vs -0.148 for VPT (p = 0.0175). Conclusion Addition of VPT to conventional management of OAG resulted in highly significant improvements in NFL and GCC trends. These results suggest VPT may elicit clinically therapeutic retinal (CNS) neuroregeneration.