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Abstract #5611 Published in IGR 2-1
Structural-functional relationships of the optic nerve in glaucoma (editorial)
Cioffi GA; Liebmann JM; Johnson CA; Weinreb RNJournal of Glaucoma 2000; 9: 3-4
This editorial deals with structural-functional relationships of the optic nerve in glaucoma. In order to understand such relationships, we need to be aware of the abilities and limitations of those tests. Visual field testing has for many years involved the determination of differential light sensitivity. New functional test have been developed to enhance the performance of functional testing. Functional testing can provide valuable clinical information. However, there is no agreed-upon standard for what constitutes abnormality of progression. The ability of any psychophysical examination to detect glaucoma or to follow progression is far from perfect. It has been shown that it is possible to predict the presence of visual field loss based upon the appearance of the optic disc. Changes in the optic nerve head precede visual field loss. Structural and functional damage appears to be topographically related. Retinal nerve fiber loss can also be observed before visual field loss. Substantial ganglion cell loss can occur before the development of visual field loss. Computerized imaging can provide a permanent record of the appearance of the optic disc and retinal nerve fiber layer. They provide objective, reproducible and accurate representations of the optic disc. However, for all these techniques, standardization of data-analysis continues to evolve. There are several shortcomings in the available studies. Small numbers of subjects, and ill defined inclusion and exclusion criteria. Most studies are cross-sectional. Only very few are longitudinal. Many studies suffer from methodological flaws, biases and other problems. There is a lack of large-scale prospective evaluation. We want to know whether any particular structural abnormality or combination of structural abnormalities is predictive of future glaucomatous visual loss. Furthermore, what is the relationship between structural optic disc changes and visual function changes in glaucoma? Probably the combination of structural and functional changes will enhance our ability to follow and diagnose glaucoma.
Classification:
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
