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Brandon DeCaluwe, Aman Shukairy, Saya Nagori, Nathan Farley, Bret Hughes, Chaesik Kim; Association between Macular Thickness and Glaucomatous Visual Field Testing. Invest. Ophthalmol. Vis. Sci. 2014;55(13):969.
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To investigate the correlation between full-thickness macular scans using Optical Coherence Tomography (OCT) data and defects on Humphrey visual field (VF) testing in patients with glaucomatous and glaucoma suspect eyes.
This was a retrospective chart review of 186 eyes of 186 patients with established diagnosis of glaucoma or glaucoma suspect. Data collected for participants included age, sex, race, intraocular pressure (IOP), visual field mean deviation (MD), pattern standard deviation (PSD) and OCT parameters including macular thickness in each quadrant. Exclusion criteria included date of service between VF and OCT testing >3 months, or >10% rates for false-negative or false-positive responses. Correlations between the macular thickness values and the visual field parameters were determined using linear regression analysis.
In our study, 76% of patients were African American, 16% were Caucasian, and 8% identified as other. The mean age of participants was 66.7 ± 13.8 years. 59% of participants were female and 41% were male. The most common glaucoma diagnoses were primary open angle glaucoma (38%) and glaucoma suspect (37%). Both the MD and PSD correlated with macular thickness. Eyes with thinner macular thickness had more negative MD scores and higher PSD scores. The inferior quadrant macular thickness was significantly correlated with MD (r = 0.476, p <.0001) and PSD (r = -0.491, p <.0001). Similarly, the superior quadrant macular thickness was associated with MD (r = 0.322, p <.0001) and PSD (r = -0.353, p <.0001). The nasal quadrant macular thickness showed a correlation with MD (r = 0.344, p <.0001) and PSD (r = -0.329, p <.0001). Finally, the temporal quadrant macular thickness was significantly correlated with MD (r = 0.270, p = .0002) and PSD (r = -0.284, p <.0001).
There was a statistically significant relationship between macular thickness and MD and PSD in patients with glaucoma and glaucoma suspect eyes. While the correlation was statistically significant in all four quadrants of the macula, the inferior macula had the highest correlation with visual field defects. This study helps to clarify the structure-function relationship between macular thickness and visual field testing. We propose that the use of full thickness macular scans, especially the inferior quadrant, may be a potential tool for screening, evaluation, and staging of disease states in glaucoma patients.
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