Relationship between parapapillary atrophy and visual field abnormality in primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Analysis

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Early detection and monitoring of POAG progression are crucial for vision preservation.
• Parapapillary atrophy (PPA) is a structural change around the optic nerve head observed in glaucoma.

Purpose of the Study:

• To determine the association between parapapillary atrophy (PPA) measurements and visual field sensitivity in POAG patients.
• To compare the diagnostic utility of standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP) in relation to PPA.

Main Methods:

• Confocal scanning laser ophthalmoscopy (CSLO) was used to assess optic nerve head topography and PPA (beta and alpha zones).
• Standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP) were employed to measure visual field sensitivity (Mean Deviation, Corrected Pattern Standard Deviation).
• Forty-seven eyes of 47 POAG patients with elevated intraocular pressure were analyzed.

Main Results:

• PPA, specifically the beta zone, was present in 49% of POAG eyes, while the alpha zone was found in all eyes.
• The area of the beta zone significantly correlated with visual field indices from both SAP and SWAP.
• Eyes with a beta zone exhibited significantly worse visual field sensitivity compared to those without.

Conclusions:

• Parapapillary atrophy, particularly the beta zone, is significantly associated with glaucomatous visual field loss.
• CSLO-measured PPA is a valuable indicator for detecting and monitoring vision impairment in POAG.
• PPA assessment can complement perimetric methods for a comprehensive evaluation of glaucoma severity.