Investigating the structure-function relationship using Goldmann V standard automated perimetry where glaucomatous...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Neuroscience

Background:

• The structure-function relationship between retinal nerve fiber layer thickness and visual field sensitivity is crucial for diagnosing glaucoma.
• Advanced glaucoma can present challenges in accurately assessing this relationship due to floor effects.

Purpose of the Study:

• To compare the Goldmann V target with the Goldmann III target for assessing the structure-function relationship in advanced glaucoma.
• To determine if the Goldmann V target offers a stronger correlation between circumpapillary retinal nerve fibre layer (cpRNFL) thickness and visual field (VF) thresholds.

Main Methods:

• Utilized optical coherence tomography (OCT) for cpRNFL thickness measurements.
• Performed visual field testing using Humphrey Field Analyzer with Goldmann III (SITA standard) and V (full-threshold) targets in 51 glaucoma patients.
• Analyzed the relationship between supero- and infero-temporal cpRNFL thicknesses and VF sensitivities.

Main Results:

• A floor effect was observed in both Goldmann III and V target visual field sensitivities around 60 μm cpRNFL thickness.
• No significant relationship was found between Goldmann V target visual field sensitivity and cpRNFL thickness when Goldmann III sensitivity was below 20 dB.

Conclusions:

• The Goldmann V target does not enhance the structure-function relationship in advanced glaucoma compared to the Goldmann III target.
• The findings suggest limitations in using standard or full-threshold visual field tests to assess structure-function in severe glaucomatous damage.