The changes of RNFL thickness and its influence on visual field defect in patients with PXG at different stages

To investigate the changes of retinal nerve fiber layer (RNFL) thickness and its influence on visual field defect in pseudoexfoliation glaucoma (PXG) patients at different stages, including early stage, middle stage and late stage.

Clinical data of 194 PXG patients who were treated in our hospital from January 2017 to December 2019 were retrospectively analyzed. All patients were grouped according to the disease stage of PXG, including 56 eyes in the early stage, 54 eyes in the middle stage and 84 eyes in the late stage. Meanwhile, 50 cases with normal eyes were selected as the control group. The baseline clinical data, visual field defect and RNFL thickness in different groups were compared and the correlation between RNFL thickness and visual field defect was analyzed.

There was no significant difference in baseline clinical data among different groups (p>0.05). There was significant difference in visual field defect and RNFL thickness among different groups (p<0.05). The visual field defect, mean, supratemporal, infratemporal and subnasal of RNFL thickness in the early group were significantly lower than those of control group (p<0.05). The visual field defect, mean, nasal, supranasal, supratemporal, infratemporal and infratemporal of RNFL thickness in the middle group were significantly lower than those of control group (p<0.05). The visual field defect and RNFL thickness in the late group were significantly lower than those of control group and early group (p<0.05). The visual field defect, mean, supratemporal, infratemporal and infratemporal of RNFL thickness in the middle group were significantly lower than those of early group (p<0.05). Pearson correlation analysis showed that there was no correlation between RNFL thickness and visual field defect in pseudoexfoliation glaucoma patients in the early stage (r=-0.09, p=0.63). There was the positive correlation between RNFL thickness and visual field defect in PXG patients in the middle and late stages (r=0.43, 0.60; p=0.04, 0.00).

RNFL thickness is closely related to visual field defect in patients with PXG in middle and late stage. Dynamic monitoring of RNFL thickness can be used for clinical diagnosis, staging and prognosis evaluation.