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Abstract #18497 Published in IGR 3-3
Relationship between visual field testing and scanning laser polarimetry in patients with a large cup-to-disc ratio
Tannenbaum DP; Zangwill LM; Bowd C; Sample PA; Weinreb RNAmerican Journal of Ophthalmology 2001; 132: 501-506
PURPOSE: To determine the relationship between quantitative nerve fiber layer measurements and visual field testing in patients with large cup-to-disc ratios. METHODS: Seventy-six patients with vertical cup-to-disc ratios by contour of at least 0.8 on stereoscopic photographs and 50 normal subjects were included. One eye was randomly selected for study. All patients underwent standard achromatic automated perimetry, short-wavelength automated perimetry, and retinal nerve fiber layer measurements with scanning laser polarimetry. Analysis of variance was used to evaluate differences between the subject groups. Significance of pairwise comparisons was determined using the Tukey-Kramer multiple comparison test. RESULTS: Statistically significant differences in nerve fiber layer measurements between patients with large cup-to-disc ratios and both abnormal standard achromatic automated perimetry and short-wavelength automated perimetry (n = 22) and patients with large cup-to-disc ratios and both normal standard achromatic automated perimetry and short-wavelength automated perimetry (n = 42) were found for superior nasal ratio, maximum modulation, ellipse modulation, and the linear discriminant function (Tukey-Kramer less than 0.05). There was no significance difference in patients with abnormal short-wavelength automated perimetry only (n = 9) compared with patients with both normal standard achromatic automated perimetry and short-wavelength automated perimetry and patients with both abnormal standard achromatic automated perimetry and short-wavelength automated perimetry. Statistically significant differences between the normal subjects and patients with large cup-to-disc ratios and both abnormal standard achromatic automated perimetry and short-wavelength automated perimetry were found for all retinal nerve fiber layer parameters, with the exception of symmetry, superior ratio, and inferior ratio. CONCLUSIONS: These results show considerable overlap in nerve fiber layer measurements in eyes with large cup-to-disc ratio and abnormal visual fields compared to eyes with large cup-to-disc ratios and normal visual fields. This may limit the clinical usefulness of scanning laser polarimetry for the detection of early glaucoma in patients with large cup-to-disc ratios. Longitudinal studies are needed to determine whether patients with large cup-to-disc ratios with normal standard achromatic automated perimetry and abnormal short-wavelength automated perimetry subsequently develop standard achromatic automated perimetry defects, and whether scanning laser polarimetry can concurrently detect progression of nerve fiber layer damage.
Dr R.N. Weinreb, Glaucoma Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0946, USA
Classification:
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)
