[The function-structure impairment pattern of optic nerves in primary open-angle glaucoma and normal-tension...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Neuroscience

Background:

• Primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG) are leading causes of irreversible blindness.
• Understanding the distinct progression patterns of visual field (VF) and retinal nerve fiber layer (RNFL) in POAG and NTG is crucial for early diagnosis and management.
• Analyzing the structure-function correspondence in different glaucoma types can provide insights into disease mechanisms.

Purpose of the Study:

• To investigate the characteristics of VF and RNFL impairment in early, middle, and late stages of POAG and NTG.
• To compare the progression patterns of VF and RNFL defects between POAG and NTG.
• To analyze the correlation between VF functional loss and RNFL structural thinning in both glaucoma types.

Main Methods:

• A cross-sectional study involving POAG patients, NTG patients, and healthy controls.
• Participants underwent comprehensive ophthalmic examinations, including Humphrey central 24-2 threshold visual field testing and optical coherence tomography for RNFL thickness measurement.
• Patients were staged based on mean defect (MD) values, and VF and RNFL data were analyzed sector-wise using Kruskal-Wallis and Pearson correlation tests.

Main Results:

• Distinct sectoral VF and RNFL impairment patterns were observed in POAG and NTG, varying with disease stage.
• In POAG, superior paracentral arch (VF) and inferior temporal sector (RNFL) showed the strongest correlation (r=0.630).
• In NTG, inferior peripheral arch (VF) and superior temporal sector (RNFL) exhibited the strongest correlation (r=0.645).

Conclusions:

• POAG and NTG exhibit unique progression patterns of VF and RNFL damage.
• The identified structure-function correlations highlight specific vulnerable areas in each glaucoma type.
• These findings contribute to a better understanding of glaucoma pathophysiology and may aid in developing more targeted diagnostic and therapeutic strategies.