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S.C. Anderson, R.H. Kardon; Correlation of Regional Thickness of the Retinal Nerve Fiber Layer (RNFL) by Optical Coherence Tomography (OCT3) with Visual Field Topography in Optic Neuropathies . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1629.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To understand the relationship between retinal nerve fiber layer thickness and corresponding visual field topography in different causes of optic neuropathy. Methods: Optical Coherence Tomography (OCT3) was used to determine the percentile score based on age–matched normal eyes for each of twelve clock–hour locations of the peripapillary retina in 72 eyes. The normal and abnormal areas (< 5th percentile) of the RNFL were correlated with the visual field (50 kinetic, 54 static perimetry, and 32 both strategies). Results: Of the 864 total number of RNFL sectors tested, 64% had normal thickness and normal corresponding area of the visual field, 20% had abnormally thinned RNFL and abnormal visual field area, 9.6% had normal RNFL but abnormal visual field, and 6.4% had abnormally thin RNFL, but normal corresponding visual field. The percent of the 12 RNFL sectors in each eye that correlated with the corresponding area of visual field was found to be 84±21%. Eyes with compressive optic neuropathy had a poorer correlation of 76±27%, due to field loss in areas with normal nerve fiber thickness. Average RNFL thickness and mean deviation of static perimetry showed a non–linear correlation that was best in non–compressive optic neuropathy. Conclusions: Sectors of regional thinning of the RNFL (<5th percentile) correlated well with visual field loss in the corresponding area in eyes with permanent loss of ganglion cell axons. In compressive optic neuropathy, there may be a mismatch of structure and function with less structural loss compared to function when a reversible component of visual field loss is present. Correlation or lack of correlation between thinning of sectors of the RNFL and their corresponding area of visual field helps to classify the mechanism of damage in optic neuropathy.
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