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Editors Selection IGR 17-4

Clinical Examination Methods: OCT: Structure-Function Relationship

Comment by Tae-Woo Kim on:

74353 Structure-Function Relationships in Perimetric Glaucoma: Comparison of Minimum-Rim Width and Retinal Nerve Fiber Layer Parameters, Amini N; Daneshvar R; Sharifipour F et al., Investigative Ophthalmology and Visual Science, 2017; 58: 4623-4631

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Structural assessment is widely used to diagnose and monitor the disease in glaucoma. Minimum rim width estimated from the Bruch membrane opening (BMO-MRW) has been proposed as an alternative structural measure. This parameter is theoretically robust due to its independence of any arbitrary reference planes and geometrically precise nature than 'cup' or 'rim' measurement based on an operator-defined disc margin. However, it is controversial whether the BMO-MRW thickness is superior to peripapillary RNFL for detection of early glaucoma or with regard to structure-function relationships in the real world.

Structure-function relationships were somewhat weaker with BMO-MRW parameters compared with pRNFL thickness in eyes with perimetric glaucoma

Amini et al. reported that structure-function relationships were somewhat weaker with BMO-MRW parameters compared with pRNFL thickness in eyes with perimetric glaucoma. In addition, the relationship was not significantly increased even after normalization of the BMO-MRW according to average BMO circumference. If a structural parameter which has a good structure-function relationship particularly in advanced disease, using that parameter can extend the useful range of structural measurements in glaucoma. The result of the study suggests that the BMO-MRW is not such a parameter normalization of BMO-MRW based on BMO area, did not significantly change the SF relationships. While this finding may suggest that BMO-MRW is not significantly influenced by the BMO circumference, this could be attributed to the limited number of eyes with extreme BMO measurements in their study. Therefore, it is likely prudent to consider such corrections in eyes in which the BMO size significantly deviates from the average values of the SD-OCT normative database.

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