Structure–Function Relationship in Glaucoma Patients With Parafoveal Versus Peripheral Nasal Scotoma

Abstract

PurposeWe evaluated whether the structure–function relationship in glaucoma patients with parafoveal scotoma or peripheral scotoma differs with the use of frequency doubling technology (FDT) or short-wavelength automated perimetry (SWAP) compared to standard automated perimetry (SAP).MethodsGlaucoma patients with isolated parafoveal scotoma (PFS) within the central 10° of fixation in 1 hemifield and those with an isolated peripheral nasal step (PNS) within the nasal periphery outside 10° of fixation in one hemifield were studied. Peripapillary retinal nerve fiber layer (RNFL) thickness was measured using spectral-domain optical coherence tomography. The topographic relationships between structure and function were investigated.ResultsIn the PNS group, superotemporal (r2 = 0.300, P = 0.001) and inferotemporal (r2 = 0.302, P = 0.001) RNFL thickness showed significant correlations with the corresponding visual field (VF) sensitivity using linear regression model in SAP. In the PFS group, temporal RNFL thickness was not correlated with nasal mean sensitivity (MS) on SAP (r2 = 0.103, P = 0.065). Using FDT, however, the temporal RNFL thickness was correlated with nasal MS in the PFS group (r2 = 0.277, P = 0.001). Using SWAP, the temporal RNFL thickness was not significantly associated with regional VF sensitivity in the PFS group (r2 = 0.052, P = 0.192).ConclusionsIn glaucoma with peripheral scotoma, the RNFL thickness was associated significantly with the corresponding VF loss in SAP, FDT, and SWAP. In eyes with PFS, however, the topographic structure–function relationships were not distinct with SAP or SWAP. Frequency doubling technology performed well in terms of structure–function correlation in glaucoma with PFS.

Vasculature–function relationship in open-angle glaucomatous eyes with a choroidal microvasculature dropout

“…Vasculature– and structure–function relationships were defined as correlation coefficients between VD parameters and thickness parameters, and the corresponding VFMS values, according to the regionalization described by Garway-Heath et al 13 . The VFMS was calculated by switching from a logarithmic dB to a nonlogarithmic dB [10 × log(1/Lambert);1/L scale] 18 , 19 . The global 24-2 VFMS was calculated as the mean of VF sensitivities in 52 points of the SAP, except 2 points just above and below the blind spot and grouped into six VF sectors: SN, N, IN, IT, T, and ST (Fig.…”

Characterizing and quantifying the temporal relationship between structural and functional change in glaucoma

“…Significant efforts have been devoted to improving the strength of the structure-function relationship, including expressing structural and functional data in similar units [ 1 ], using potentially more sensitive structural [ 2 , 3 ] and functional [ 39 ] tests, and focusing on specific sectors [ 2 ] or on the macular region [ 40 ]. While these efforts have resulted in modest improvements, the associations between structure and function remain weak.…”

Increased prelaminar tissue thickness in patients with open-angle glaucoma and type 2 diabetes

“…Then they were classified into two groups including patients with and without involvement of the central 10° of the VF. [20, 21] The VF defect was classified independently in random order and in a blinded manner, without knowledge of the clinical information, by 2 of the authors (J,-A.C., and Y,-S.S).…”