Abstract
Purpose: :
To evaluate segmental macular thickness in patients with advanced glaucoma defined by anatomic and perimetric criteria and to compare these areas normal patients without glaucoma (controls).
Methods: :
Twenty nine patients (41 eyes) with advanced glaucoma, and nineteen (36 eyes) age matched controls were evaluated. All participants had a full ophthalmic evaluation and visual field testing with a Humphrey Field Analyzer (Carl Zeiss Ophthalmic Systems, Inc. Dublin), or an Octopus 1,2,3 (Interzeag AG, Zurich). Glaucoma patients had advanced optic nerve damage (Cup to disc ratio greater than 0.7 with rim thinning) with corresponding visual field deterioration. Perimetric damage was classified according to the AGIS study. Controls had normal optic nerves, normal visual fields and no evidence of any ophthalmic disease. Macular thickness was measured with Stratus OCT and divided in inferior, nasal, superior and temporal areas. The protocol used for image acquisition was Macular Thickness Map and the Retinal Thickness/Volume Analysis protocol was used for processing. Statistical analysis was perform using Instat graphpad software.
Results: :
The mean (+ Standard Deviation) macular thickness (in microns) for the different segments were the following: Temporal: Glaucoma 234 (13) vs Control 263,4 (11,9) (p < .001); Superior: Glaucoma 250,9 (19) vs Control 282,7 (12.4) (p < .001); Nasal: Glaucoma 256,6 (22.1) vs Control 281,3 (15.1) (p < .001); Inferior: Glaucoma 244,1 (19.4) vs Control 276,6 (13.5) (p < .001). Macular thickness was significantly reduced in temporal and inferior areas when compared to the nasal and superior (p< .001).
Conclusions: :
These results indicate that the four macular segments are significantly thinner in patients with advanced glaucoma when compared to controls. Temporal and inferior areas are affected earlier in the macula of eyes with advanced glaucoma. Monitoring these areas may allow earlier detection of progression.
Keywords: macula/fovea • intraocular pressure • visual fields