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Correlation between hemifield visual field damage and corresponding parapapillary atrophy in normal-tension glaucoma
Junko Kawano1, Atsuo Tomidokoro, Chihiro Mayama
1Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
American Journal of Ophthalmology
|July 4, 2006
Summary
In normal-tension glaucoma, the inferior parapapillary atrophy area significantly predicts visual field damage. Axial length and myopia are associated with both superior and inferior parapapillary atrophy areas.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Optic Nerve Head Imaging
Background:
- Normal-tension glaucoma (NTG) is a progressive optic neuropathy characterized by visual field damage without elevated intraocular pressure.
- Parapapillary atrophy (PPA), an area of chorioretinal atrophy around the optic disc, is a known indicator of glaucomatous damage.
- Understanding the relationship between specific PPA regions and visual field defects is crucial for NTG management.
Purpose of the Study:
- To investigate the correlation between the superior and inferior halves of parapapillary atrophy (PPA) and corresponding hemifield visual field damage (VFD) in normal-tension glaucoma (NTG).
- To identify specific PPA regions that are predictive of glaucomatous visual field defects in NTG patients.
Main Methods:
- A cross-sectional study involving 109 eyes of 109 consecutive NTG patients.
- Optic nerve head topography and PPA (zone beta) area were measured using the Heidelberg Retina Tomograph (HRT).
- Visual field damage (VFD) was assessed using the Humphrey Field Analyzer (30-2 program); PPA and VFD were analyzed separately for superior and inferior regions.
Main Results:
- A significant correlation was found between the inferior PPA area and superior hemifield VFD (Rs = -0.32, P < .001).
- No significant correlation was observed between the superior PPA area and inferior hemifield VFD (Rs = 0.05, P = .6).
- Multiple regression revealed that axial length and superior hemifield VFD were significantly associated with the inferior PPA area.
Conclusions:
- In NTG patients, only the inferior PPA area shows a significant correlation with glaucomatous visual field damage.
- Axial length and myopia are associated with both superior and inferior PPA areas, suggesting their role in optic nerve head remodeling.
- These findings highlight the potential of regional PPA analysis in assessing glaucoma progression.