Ocular Dominance in Open-angle Glaucoma: The Shifting Trend Depending on Stage of the Disease

Abstract

Purpose: To investigate the characteristics and distribution of ocular dominance in primary open-angle glaucoma (OAG) eyes. In addition, we tried to catch any trend of ocular dominance according to the stage of disease.Methods: Two hundred participants with bilateral OAG underwent ocular dominant testing by 'the holein-a-card' test. Using optical coherence tomography, macular ganglion cell-inner plexiform layer (GCIPL), as well as circumpapillary retinal nerve fiber layer thickness (RNFLT) were measured and compared according to ocular dominance. Of the two eyes of one subject, the eye with less glaucomatous damage based on mean deviation (MD) was considered to be the 'better eye' in our study.Results: Ocular dominance was in the right eye in 66% of the population and ocular dominance was positioned in the better eye in 70% of the population (p= 0.001 and 0.002, respectively). In conditional logistic regression analyses, right eye and better MD were significantly associated with ocular dominance (p= 0.001 and 0.002, respectively). Ocular dominance tends to be present in the better eye and this trend was more apparent as the severity of glaucoma increased. Inter-eye comparison of visual field indices and RNFLT between dominant vs non-dominant eye become apparent in moderate and advanced glaucoma whereas it was not as apparent in early glaucoma. Conclusions:In glaucomatous eyes, laterality and severity of glaucoma determined ocular dominance.Inter-eye difference between non-dominant and dominant eyes increased with the severity of glaucoma.Our findings suggest the existence of potential reciprocal interactions between ocular dominance and glaucoma.