J Korean Ophthalmol Soc.  2010 Dec;51(12):1606-1613.

Comparison Between Retinal Nerve Fiber Layer Change and Visual Field Change in Normal Tension Glaucoma

• Lee WH
• Sung MS
• Shin JW
• Lee JH

Abstract

PURPOSE
To evaluate longitudinal changes in retinal nerve fiber layer thickness (RNFL) and visual field in patients with normal tension glaucoma (NTG).
METHODS
Thirty eyes of 30 NTG patients and 30 eyes of 30 normal control subjects were enrolled in the present study. RNFL thickness was measured using optical coherence tomography (OCT), and visual field tests were performed using a Humphrey visual field analyzer at baseline and 23.3 +/- 15.3 months later. Changes in RNFL thickness at each clock-hour segment and visual field sensitivities were analyzed. The rates of change in RNFL thickness were also calculated.
RESULTS
Significant differences in RNFL thickness were observed between NTG patients and normal control subjects at the 5, 6, 7 and 12 o'clock positions at baseline (p < 0.001). At follow-up, the RNFL thickness change was not significant for normal control subjects, although it was significant for NTG patients at the 4, 5, 6, 7, 11 and 12 o'clock positions (p < 0.001). Visual field parameters did not change significantly in the normal control subjects or NTG patients. The reduction rates of RNFL thickness were 0.38 microm/month for the NTG patients and 0.11 microm/month for the normal control group, displaying a 3.5-fold faster reduction rate for NTG patients.
CONCLUSIONS
The NTG group showed greater reductions in RNFL thickness in the upper and lower sectors over time; however, the visual field parameters did not change significantly. The results suggest that progression of glaucoma can be detected in an earlier stage using OCT than can be detected using a visual field test.

Keyword

Longitudinal study; Normal tension glaucoma; Optical coherence tomography; Retinal nerve fiber layer thickness; Visual field test

MeSH Terms

Eye
Follow-Up Studies
Glaucoma
Humans
Longitudinal Studies
Low Tension Glaucoma
Nerve Fibers
Retinaldehyde
Tomography, Optical Coherence
Visual Field Tests
Visual Fields
Retinaldehyde

Figure

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  Figure 1. Distribution of visual field (VF) zones and associated short-wavelength automated perimetry test points relative to temporal (T) and nasal (N) retinal positions. Odd-numbered VF zones are shaded gray.

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  Figure 2. Optical coherence tomography 30-degree sectors in a clock hour distribution relative to temporal (T) and nasal (N) retinal positions.

Reference

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