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F. K. Horn, R. P. Tornow, A. M. Juenemann, R. Laemmer, F. E. Kruse, C. Y. Mardin; Correlation Between Local Glaucomatous Visual Field Defects and Loss of the Nerve Fiber Layer Thickness Measured With Polarimetry (GDx) and Spectral Domain OCT. Invest. Ophthalmol. Vis. Sci. 2008;49(13):732.
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To measure peripapillar nerve layer thickness in healthy subjects and glaucoma patients using polarimetry and high resolution optical coherence tomography. Local perimetric field defects were correlated with thickness reduction of the nerve layer in corresponding retinal areas.
Thickness values of the retinal nerve fiber layer were determined in 32 sectors (11.25° each) using the GDx with variable cornea compensation (Zeiss-Humphrey) and a newly introduced high resolution OCT (Spectralis, Heidelberg Engineering). Diameter of calculation circles were used as recommended by the manufacturers. 38 healthy subjects served as controls to determine thickness deviation in glaucoma patients. Relation between glaucomatous nerve fiber reduction and visual field losses were calculated in six nerve fiber bundle related areas. 37 patients with different stages of open angle glaucoma underwent perimetry (Octopus G1) and measurements with both morphometric techniques. Due to possible non-linear relationships between perimetric defects and thickness of nerve fiber layer, non-parametric and parametric correlations were studied.
Thickness loss of nerve fiber layer was highest in superior and inferior bundles for both morphometric measurement devices. Differences between both techniques, which were observed in the superior and inferior nerve fiber bundles, are probably due to different calculation circles. Sector-shaped analyses between local perimetric losses and loss of the retinal nerve fiber layer thickness showed a clear association for corresponding areas. The correlation coefficients were highest (p<0.001) for arcuate superior and inferior visual field zones abutting the nasal horizontal raphe. Correlation coefficients ranged between 0.52 (nasal field) and 0.69 (nasal inferior) for the OCT and between 0.10 (nasal) and 0.69 (inferior) for polarimetry.
Localized perimetric defects in the arcuate bundles of the visual field can be explained by reduced nerve fiber layer thickness. These preliminary data indicate that the present spectral domain OCT is a promising new technique for determining this functional-structural relationship due to its high resolution and an implemented tracking system.
Clinical Trial: :
www.clinicaltrials.gov NCT 00494923
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