Correlations of peripapillary retinal nerve fiber layer and macula thicknesses with visual field defects in patients with glaucoma

Abstract

BACKGROUND: The optic disc and peripapillary retinal nerve fiber layer (RNFL) have been structurally evaluated to detect early glaucomatous changes. Recent imaging technology developments that allow quantifying these structural changes may contribute to the early detection of glaucomatous damage. Optical coherence tomography (OCT) is an important diagnostic tool in structurally diagnosing glaucoma. The primary diagnostic tool for glaucoma is OCT-based peripapillary RNFL thickness. Glaucoma is now believed to also damages the macula, which contains many retinal ganglion cell layers.METHODS: This observational case-control study compared the diagnostic abilities of peripapillary RNFL and macular OCTs with Humphrey visual field examinations in detecting glaucoma. The RNFL, ganglion cell-inner plexiform layer (GCIPL), and total macular (TMT) thicknesses were compared between groups using analysis of variance. The correlations of RNFL, GCIPL, and TMT thicknesses with the Humphrey test’s mean deviation (MD) and pattern standard deviation were assessed using Pearson’s correlation coefficient. A P value <0.05 was considered statistically significant.RESULTS: Peripapillary RNFL and GCIPL thicknesses differed significantly between patients with glaucoma, suspected glaucoma, ocular hypertension, and healthy subjects. In patients with glaucoma, peripapillary RNFL thickness was strongly positively correlated with MD. Similarly, their GCIPL thickness was strongly positively correlated with MD. GCIPL thickness could differentiate patients with early glaucoma from healthy subjects, and its diagnostic ability was comparable to RNFL thickness. RNFL thickness discriminates patients with suspected glaucoma from healthy subjects better than GCIPL and TMT.CONCLUSIONS: GCIPL OCT can complement peripapillary RNFL OCT to detect early glaucoma. GCIPL OCT can detect glaucoma in patients with optic disc abnormalities or peripapillary atrophy that make RNFL OCT difficult to perform.

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