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Takeshi Yabana, Kazuko Omodaka, Mai Takahashi, Noriko Himori, Morin Ryu, Kazuichi Maruyama, Toru Nakazawa; Useful Diagnostic Tool for Progressive Visual Acuity Decrease in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3922. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Macular retinal thickness, especially at the temporal side of the optical disc, is sometimes associated with a progressive decrease of visual acuity in glaucoma patients. The purpose this present study was to develop a simple and useful tool for the analysis of visual acuity that is associated with visual function of the Humphrey field analyzer (HFA) or macular retinal thickness in glaucoma patients.
This study involved 60 eyes of 34 patients with open-angle glaucoma. Measurements of the retinal nerve fiber layer (RNFL), the ganglion cell complex (GCC), and the ganglion cell layer plus inner plexiform layer (GCL+IPL) in all eyes were obtained by use of an optical coherence tomography (OCT) macular map (3D-OCT2000; TOPCON Corporation, Tokyo, Japan). To retrieve reliable threshold values, the total deviation (TD) and the pattern deviation (PD) were collected by use of the HFA SITA-standard 10-2 program. Spearman’s rank correlation coefficient analysis was used to investigate the correlation between visual acuity and macular retinal thickness of each grid (2i four quarters) at the site of the macular area, and the correlation with visual acuity and each 68 points of the HFA parameters.
OCT macula map findings showed that visual acuity correlated with the thickness of the RNFL (r = -0.31~-0.54) and the GCC (r = -0.31~-0.50) at the nasal side of the upper area of fovea. Moreover, the GCL+IPL (r = -0.31~-0.51) in the papillomacular bundle was found to be correlated with visual acuity. The HFA results showed that visual acuity was in accordance with TD (r = -0.39~-0.56), the measured threshold values (r = -0.36~-0.55), and PD (r = -0.23~-0.50), which were in accordance with the papillomacular bundle area.
In the glaucoma patients involved in this study, visual acuity was found to be strongly correlated with macular retinal thickness or visual function of HFA in the papillomacular bundle area. These findings indicate that the combined quantitative analysis of these examinations is a useful diagnostic tool for the possible progressive visual acuity decrease in glaucoma patients.
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