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Mapping structural damage of the optic disk to visual field defect in glaucoma
N Yamagishi1, A Anton, P A Sample
1Department of Ophthalmology, University of California, San Diego, La Jolla 92093-0946, USA.
Purpose:
To evaluate the relation between the location of focal visual field defects and optic disk damage in eyes with glaucoma by short-wavelength automated perimetery and confocal scanning laser ophthalmoscopy.
Methods:
In 14 patients (14 eyes) with open-angle glaucoma, focal optic disk damage, and focal visual field loss, we obtain visual fields with short-wave-length automated perimetry. The short-wavelength automated perimetry visual field was divided into 21 zones, representing retinal nerve fiber layer arcuate bundles. Test points were compared with a normative database. The optic disk was assessed with a confocal scanning laser ophthalmoscope. Optic disk measurements were calculated in 10-degree sectors and compared with a normative database using a new measure, the rim area ratio, which adjusts for individual differences in disk size.
Results:
The mean number (+/-SD) of damaged visual field zones was 3.9 (+/-1.9), and the mean number of damaged rim sectors was 5.0 (+/-2.9). Focal defects on the optic disk and on short-wavelength automated perimetry were topographically related with specific damaged visual field zones corresponding to specific damaged rim sectors.
Conclusions:
In patients with open-angle glaucoma with focal optic disk damage and focal visual field loss, defects in optic disk and short-wavelength automated perimetry are topographically related. The rim area ratio can be used to identify focal optic nerve defects.