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Foveal dysfunction and central visual field loss in glaucoma
A Weiner1, D J Ripkin, S Patel
1Division of Ophthalmology, St Luke's Medical Center, Cleveland, Ohio 44104, USA. aweinerbo@aol.com
Objective:
To determine whether foveal function distal to the ganglion cell layer is an independent predictor of central visual field function in glaucoma.
Setting:
University affiliated hospital and private practice.
Participants:
Twenty-seven eyes (27 patients) with normal-pressure glaucoma, 10 eyes (10 patients) with primary open-angle glaucoma, and 47 eyes of 47 matched normal volunteers.
Intervention And Main Outcome Measures:
Foveal cone electroretinogram (ERG) amplitude, relative optic cup to disc area and their relations to Humphrey full-threshold 30-2 visual field central 4-point mean total deviation (C4MTD) and pattern deviation (C4MPD).
Results:
Foveal cone ERG amplitude was subnormal in 14 (37.8%) of the 37 glaucomatous eyes and lower in the glaucoma group compared with normal eyes (P<.01). The C4MTD and C4MPD were lower in glaucomatous eyes with subnormal amplitudes compared with those with normal amplitudes (P<.01 and P<.05, respectively). Amplitude was directly correlated with C4MTD (P<.01) and C4MPD (P<.01). Relative optic cup to disc area was inversely correlated with C4MTD (P<.001) and C4MPD (P<.001). Partial correlation analysis revealed that amplitude and relative optic cup to disc area were independent predictors of C4MTD and C4MPD.
Conclusion:
Foveal function distal to the ganglion cell layer and optic disc cupping independently predict central visual field function in glaucoma.