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Comparison of the Structure-Function Relationship Between Advanced Primary Open Angle Glaucoma and Normal Tension
Mi Sun Sung1, Yong Sok Ji, Hwan Heo
1Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju, South Korea.
Journal of Glaucoma
|May 18, 2022
Summary
Primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG) show distinct visual field defect patterns in advanced stages. Retinal nerve fiber layer and macular measurements correlate well with visual function, especially in NTG.
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 characteristics of visual field (VF) defects and structure-function relationships in advanced glaucoma is crucial for patient management.
- Previous studies have not fully elucidated the differences in VF patterns and structural correlates between POAG and NTG in advanced stages.
Purpose of the Study:
- To compare the characteristics of visual field defects in advanced POAG and NTG.
- To investigate and contrast the structure-function relationships in advanced POAG and NTG.
- To determine if glaucoma classification influences the structure-function relationship in advanced glaucoma.
Main Methods:
- Cross-sectional study including 97 eyes with advanced glaucoma (59 POAG, 38 NTG).
- Analysis of 30-2 visual field test point scores and comparison between POAG and NTG groups.
- Measurement of peripapillary retinal nerve fiber layer (RNFL) and macular thickness (total, RNFL, ganglion cell layer, inner plexiform layer).
- Assessment of structure-function relationships using the Garway-Heath map.
Main Results:
- POAG eyes exhibited more diffuse visual field defects, while NTG eyes showed more severe, asymmetric defects in the superior nasal quadrant.
- Peripapillary RNFL, macular ganglion cell layer, and inner plexiform layer thickness correlated well with visual field parameters in both groups.
- Structure-function relationships for total macula and macular RNFL thickness differed between POAG and NTG, with NTG showing better correlations.
Conclusions:
- Distinct patterns of visual field damage exist between POAG and NTG in advanced glaucoma.
- Conventional peripapillary RNFL and macular thickness measurements are effective for assessing visual function, particularly in NTG eyes.
- Glaucoma classification impacts the structure-function relationship in advanced stages of the disease.
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