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Monica Mosca, Alessandro Rossi, Giorgio Gagliano, Roberto Ratiglia; Comparison of Functional and Structural Alterations in Advanced Open Angle Glaucoma with Standard Automated Perimetry, Microperimetry and Spectral Domain OCT. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5080.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the agreement between standard automatic perimetry (SAP) and microperimetry (MP1) in POAG eyes with advanced visual field (VF) defects and the eventual correlation with macular and retinal nerve fiber layer (RNFL) alterations.
Cross-sectional study on 20 POAG patients (20 eyes) with advanced VF defects as defined by Hodapp classification (9 males, 11 females, mean age 68.4±10 years) and 20 normal subjects (20 eyes) (7 males, 13 females, mean age 61.2±8.4 years). All subjects underwent: complete examination, Spectralis HRA+OCT imaging of macula and RNFL, SAP (Humphrey prog.10-2 SITA standard), Nidek MP1 microperimetry (prog. Humphrey 10-2 pattern, 4-2 strategy, Goldmann III size stimulus projected on a white background). Paired Student t-test and Pearson’s correlation coefficient (r) between the considered parameters were used for statistical analysis.
Macular sensitivity was significantly inferior in POAGs than controls with both SAP and MP1 (p<0.001) either as mean total macular sensitivity, either as mean sensitivity in all 4 VF quadrants. There was a significant correlation (p=0.000) between SAP and MP1 mean total macular sensitivity (r=0.752 in POAG eyes; r=0.98 in normal eyes) and mean sensitivity of each of the 4 VF quadrants (IT: r=0.93; IN: r=0.81; ST: r=0.72; SN: r=0.78 in POAG eyes; IT: r=0.92; IN: r=0.96; ST: r=0.93; SN: r=0.81 in normal eyes). A significant difference (p<0,001) in macular thickness, macular volume and average RNFL thickness between POAG and control group was found (291.28±12.4µm vs 316.2±11.3µm; 7.2±0.4mm3 vs 6.92±0.6mm3 and 57.17±7.7µm vs 91.75±6.5µm respectively). OCT parameters showed a poor correlation with SAP mean total sensitivity in both groups. In POAG patients, MP1 mean total sensitivity showed a good correlation with macular thickness (r=0.67, p=0.001) and sufficient with average RNFL thickness (r=0.45, p=0.04); in normal subjects only a mild correlation with macular volume (r=-0.48, p=0.02) and with macular thickness (r=-0.45, p=0.04) was found.
MP1 and SAP findings showed a very good correlation but MP1 results agreed with a corresponding OCT macular thinning, suggesting to be more sensitive than SAP to detect central VF loss in glaucomatous patients.
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