Difference in the posterior pole profiles associated with the initial location of visual field defect in early‐stage normal tension glaucoma

Choi, Jung Sik; Park, Chan Kee

doi:10.1111/aos.12492

Cited by 20 publications

(25 citation statements)

References 28 publications

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“…The unequal prevalence of parafoveal scotoma between hemifields has been extensively investigated and our results are consistent with those of previous reports. 3,17,18,[30][31][32][33][34] It was reported that macular structural parameters using spectral-domain OCT may be potentially useful predictors of the presence of parafoveal scotoma. [35][36][37] In accordance with the previous findings, our current results showed that the average and minimum mGCIPL thickness in eyes with parafoveal scotoma was significantly thinner than in eyes without parafoveal scotoma.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15] However, little is known about their relationship to the pattern of VF defects. Although, several reports identified anatomic factors that can influence the development of parafoveal scotoma in early glaucoma, 16,17 the subjects included in these studies were NTG patients and not confined to the myopic subpopulation. From a clinical perspective, patients with myopic NTG have been reported to be more susceptible to papillomacular bundle damage, which is associated with parafoveal scotoma, and the pathomechanism of optic nerve damage in eyes with myopic NTG might be different from that in eyes with non-myopic NTG.…”

Section: Introductionmentioning

confidence: 99%

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Predicting the risk of parafoveal scotoma in myopic normal tension glaucoma: role of optic disc tilt and rotation

Sung

Heo

et al. 2017

Eye

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PurposeThe purpose of the study was to evaluate the factors associated with development of parafoveal scotoma in early myopic normal tension glaucoma (NTG).Patients and methodsNinety-nine myopic NTG patients with mean deviation (MD) >-6.0 decibels (dB) were enrolled. Parafoveal scotoma was defined as a visual field (VF) defect within 10° of fixation with at least one point at P<1% lying at the four innermost central points. Systemic factors, optic disc characteristics including tilt ratio, rotation degree, β-zone parapapillary atrophy, disc hemorrhage, and peripapillary retinal nerve fiber layer and macular ganglion cell-inner plexiform layer (mGCIPL) thickness parameters using optical coherence tomography were evaluated. Logistic regression analysis was performed to identify factors associated with the development of parafoveal scotoma.ResultsThe mean spherical equivalent refractive error and MD were -6.07±2.83 diopters and -3.29±1.70 dB, respectively. Among 99 eyes, 42 (42.42%) showed parafoveal scotoma. Eyes with parafoveal scotoma had greater disc tilt, lesser disc rotation, lower MD, thinner minimum mGCIPL, and a higher proportion of VF defect in the superior hemifield than eyes without parafoveal scotoma. Multivariate logistic regression showed that all these parameters were significantly associated with development of parafoveal scotoma (P=0.047, P=0.011, P=0.032, P=0.010, and P=0.001, respectively).ConclusionIn addition to the previously reported risk factors, optic disc characteristics, such as tilt ratio and optic disc rotation, were also significantly associated with development of parafoveal scotoma in patients with myopic NTG.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predicting the risk of parafoveal scotoma in myopic normal tension glaucoma: role of optic disc tilt and rotation

Sung

Heo

et al. 2017

Eye

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“…The disc centre-fovea line was defined as line connecting the centre of the disc with the fovea. The disc centre was assessed as the point where the longest diameter and shortest diameter of the optic disc cross 44 . The location Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of Normal-tension Glaucoma Patients with Temporal Retinal Nerve Fibre Defects

Yum

2020

Sci Rep

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Glaucomatous visual field (VF) damage usually involves in the Bjerrum area, which refers to outside the central 10° region. However, some reports suggest that structural damage to the macula occurs even in the early stages of glaucoma. We investigated the characteristics of normal tension glaucoma (NTG) patients with temporal retinal nerve fibre layer (RNFL) defects. Ninety eyes from 90 subjects including 30 normal eyes, 30 eyes of 30 patients with normal-tension glaucoma with temporal RNFL defects, and 30 eyes of 30 patients with normal-tension glaucoma with inferotemporal or superotemporal RNFL defects were enrolled. The best-corrected visual acuity (BCVA) decreased significantly in glaucomatous eyes with temporal RNFL defects as compared with in controls and glaucomatous eyes with inferotemporal or superotemporal RNFL defects. VF tests showed more frequent central or cecocentral VF defects involving the central 10° region in glaucomatous eyes with temporal RNFL defects. VF defects were more frequently detected on short-wavelength automated perimetry (SWAP). Eyes with temporal RNFL defects had generally reduced ganglion cell-inner plexiform layer (GCIPL) thickness. In addition, the BCVA, GCIPL thicknesses, and SWAP findings were significantly different in glaucoma patients with temporal RNFL defects according to their colour vision deficiency, not RNFL thickness or standard automated perimetry (SAP) results. Glaucoma is a major cause of blindness worldwide 1. It is a neurodegenerative disorder characterized by a progressive loss of retinal ganglion cells (RGCs) and their axons. Retinal nerve fibre layer (RNFL) defects in glaucoma patients are most frequently found in the inferotemporal region, followed by the superotemporal region 2,3. Visual field defects caused by glaucoma usually involve the Bjerrum region, which refers to the arcuate-shaped scotoma outside the central 10° region 4. However, some glaucoma patients have RNFL damage close to the central region in the retina, the temporal region of the optic disc, and present with paracentral or central scotoma in the visual field 2. Several studies have reported that early glaucomatous damage can affect the macular area 5-10. A recent investigation demonstrated that macular involvement and central and paracentral VF defects can occur even in the early stages of glaucoma 11,12. In addition, eyes with initial parafoveal scotoma have significantly different baseline characteristics from eyes with peripheral scotoma in glaucoma 13. We assumed that normal-tension glaucoma (NTG) patients with temporal RNFL defects may have apparent structural differences regarding optic nerve head (ONH) and visual field defects as compared with NTG patients with inferotemporal or superotemporal RNFL defects. Therefore, we investigated the characteristics of NTG patients with temporal RNFL defects. An analysis was conducted to compare optic disc parameters and the RNFL thickness profile with macular ganglion cell analysis (GCA) maps determined by Cirrus high-definition optical cohere...

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“…Eyes with a larger disc-foveal angle are reported to have frequent superior central VF defects. 17 The inferior foveal location relative to the optic disc results in a distinct asymmetric distribution of the RNFL between the superior and inferior retina, particularly in papillomacular bundle fibers originating from the central retina. As Hood explained, this causes crowding of the papillomacular bundles at the inferotemporal disc at the level of the LC and this may contribute to the regional susceptibility of the inferotemporal LC.…”

Section: Lamina Cribrosa Defects and Associated Factors H-yl Park Et Almentioning

confidence: 99%

Ocular characteristics associated with the location of focal lamina cribrosa defects in open-angle glaucoma patients

Park

Hwang

Park

2016

Eye

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Purpose To investigate the clinical characteristics according to the location of focal lamina cribrosa (LC) defects and its associated ocular features. Patients and methods A total of 139 openangle glaucoma patients underwent Spectralis optical coherence tomography (OCT) with enhanced depth imaging. Alterations in the contour of the LC were investigated to find focal LC defects. The location of the visible LC defect from the neural canal wall (farperipheral and mid-peripheral) and clockhour position (superotemporal, temporal and inferotemporal) were classified. Disc ovality ratio and disc-foveal angle were measured from disc and retinal nerve fiber layer (RNFL) photographs. The disc tilt degree was measured using a Heidelberg Retina Tomograph (HRT) III system. The en face OCT image of the disc scans was registered to the disc and RNFL photographs, to determine whether the focal LC defects corresponded spatially to the glaucomatous damage location. Results Eyes with far-peripheral LC defects were significantly myopic and had a higher disc ovality ratio. The disc tilt degree obtained by HRT revealed significant temporal disc tilt in eyes with temporal LC defects (Po0.001). Eyes with inferotemporal LC defects had a significantly larger discfoveal angle (P = 0.027). The inferotemporal LC defects corresponded to the location of glaucomatous damage in 81.6%; however, only 46.2% of eyes with a superotemporal LC defect and 3.2% of eyes with a temporal LC defect corresponded spatially with the glaucomatous damage location. Conclusions The clinical characteristics and association with glaucomatous damage location were different according to the location of focal LC defect.

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Difference in the posterior pole profiles associated with the initial location of visual field defect in early‐stage normal tension glaucoma

Cited by 20 publications

References 28 publications

Predicting the risk of parafoveal scotoma in myopic normal tension glaucoma: role of optic disc tilt and rotation

Predicting the risk of parafoveal scotoma in myopic normal tension glaucoma: role of optic disc tilt and rotation

Characteristics of Normal-tension Glaucoma Patients with Temporal Retinal Nerve Fibre Defects

Ocular characteristics associated with the location of focal lamina cribrosa defects in open-angle glaucoma patients

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