Structural and functional assessment of the macular region in patients with glaucoma

Abstract

Purpose: To investigate the correlation of a structural measure of the macular area (optical coherence tomography (OCT)) with two functional measures (10-2 Humphrey visual field (HVF) and multifocal visual evoked potential (mfVEP)) of macular function. Methods: 55 eyes with open-angle glaucoma were enrolled. The 10-2 HVF was defined as abnormal if clusters of >3 points with p,5%, one of which had p,1%, were present. The mfVEP was abnormal if probability plots had >2 adjacent points with p,1%, or >3 adjacent points with p,5% and at least one of these points with p,1%. Two criteria were used for the macular OCT: (I) >2 sectors with p,5% or 1 sector with p,1% and (II) 1 sector with p,5%. Results: 54 of the 55 eyes showed an abnormal 10-2 HVF and 50 had central mfVEP defects. The two OCT criteria resulted in sensitivities of 85% and 91%. When both functional tests showed a defect (in 49 eyes), the OCT was abnormal in 45. For the OCT the outer and inner inferior regions were the most likely to be abnormal, and both functional techniques were most abnormal in the superior hemifield. Conclusions: Good agreement exists between macular thickness and functional defects in patients with glaucoma. Study of the macular region may provide a quantitative measure for disease staging and monitoring.

Structural and functional assessment by hemispheric asymmetry testing of the macular region in preperimetric glaucoma

“…This result was in agreement with Orzalesi's report that documented the presence of decreased retinal sensitivity corresponding to a localized RNFLD using a high density of targets in scanning laser ophthalmoscopy [7]. Kanadani et al [26] evaluated the macular area in glaucoma patients with an HFA 10-2 threshold test and reported that 98.2 % of eyes with glaucoma had perimetric changes. The 24-2 distribution of test locations in the central 10°was limited to 12 locations, each separated by 6°.…”

The 2-global flash mfERG in glaucoma: attempting to increase sensitivity by reducing the focal flash luminance and changing filter settings

“…This may reflect a more focal glaucomatous damage in the patients that may be lost if larger areas are averaged together. Our finding of a significant central loss in the RMS amplitudes of the DC, IC-1, and IC-2 of the 2-global flash mfERG is in agreement with previous reports of macular involvement in glaucoma [20][21][22]. It is also consistent with previous OCT findings of macular involvement in glaucoma, where a qualitative reduction in the thickness of the RGC layer by computeraided manual segmentation procedure corresponds to local losses in visual field sensitivity [23].…”

Detecção de perda neural localizada através da redução da espessura macular na tomografia de coerência óptica: relato de caso

“…Diversos autores demonstraram que a perda de alguns setores da espessura macular tiveram uma correlação tão boa com o defeito de campo visual quanto à perda da CFNR em pacientes com atrofia em banda do nervo óptico (7) . Outros autores demonstraram que em pacientes portadores de glaucoma em estágios mais avançados, a redução na espessura macular foi mais significativa na região macular inferior e apresentou melhor correlação com os defeitos funcionais do que aquela obtida com a CFNR peripapilar (10) . A avaliação da espessura macular pode também ser importante quando se pretende quantificar a perda neural em afecções do nervo óptico que cursam com edema do disco óptico.…”