Retinal nerve fiber loss pattern in high-tension glaucoma by optical coherence tomography

Area of Science:

• Ophthalmology
• Glaucoma Research
• Medical Imaging

Background:

• Glaucoma is a leading cause of irreversible blindness.
• High-tension primary chronic open-angle glaucoma (HT-PCOAG) is a subtype characterized by elevated intraocular pressure.
• Understanding the pattern of retinal nerve fiber layer (RNFL) damage is crucial for early diagnosis and management.

Purpose of the Study:

• To characterize the specific pattern of RNFL thinning in patients with HT-PCOAG.
• To utilize optical coherence tomography (OCT) for quantitative assessment of RNFL thickness.
• To correlate RNFL changes with glaucoma severity.

Main Methods:

• Retinal nerve fiber layer thickness was measured using OCT.
• 68 healthy controls and 68 age- and refractive error-matched HT-PCOAG patients were recruited.
• HT-PCOAG patients were stratified into early, moderate, and moderately advanced disease based on visual field mean deviation.

Main Results:

• Significantly reduced RNFL thickness was observed in inferotemporal and superotemporal regions in all HT-PCOAG groups compared to controls (P<0.001).
• In early-stage HT-PCOAG, inferotemporal RNFL thickness was significantly lower than superotemporal thickness (P<0.001).
• This regional difference was not significant in moderate and moderately advanced stages.

Conclusions:

• Early-stage HT-PCOAG may exhibit both diffuse RNFL defects and localized inferotemporal thinning.
• OCT provides valuable quantitative data for assessing the location and extent of RNFL injury in glaucoma.
• Findings align with existing knowledge on glaucoma pathophysiology and imaging.