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E.M. Hoffmann, F.A. Medeiros, P.A. Sample, R.R. A. Bourne, C. Boden, C. Bowd, L.M. Zangwill, R.N. Weinreb; Relationship Between Patterns of Visual Field Loss and Scanning Laser Polarimetry–Derived Retinal Nerve Fiber Layer Measurements in the Diagnostic Innovations in Glaucoma Study (DIGS) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2480.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the association between patterns of visual field (VF) loss and retinal nerve fiber layer (RNFL) thickness measurements obtained with scanning laser polarimetry (GDX VCC). Methods: 121 glaucoma patients and 65 normal controls were included. (Mean age 67.0 years±12.0 years and 65.0 years± 8.7 years, respectively). All glaucoma patients had repeatable abnormal VFs using standard automated perimetry (SAP SITA) and GDx VCC imaging within six months. GDx VCC RNFL thickness measurements were obtained from 16 equal parapapillary sectors. Patterns of VF loss were classified as arcuate, partial arcuate, nasal step, or paracentral in each VF hemifield. Logistic regression analysis was performed to determine which RNFL sectors were associated with each VF pattern. The ability of GDx VCC to discriminate between patients with different VF patterns and normal controls using ROC curve analyses was also investigated. Results:Arcuate (n=29), partial arcuate (n=29) nasal step (n=17), and paracentral (n=18) VF patterns in the superior hemifield were significantly associated with RNFL sectors in the temporal and temporal–inferior hemiretina (P < 0.001). ROC curve areas for discrimination between patients with patterns of VF loss and normal controls ranged from 0.85 to 0.95. VF patterns in the inferior hemifield (Arcuate, n=12, partial arcuate, n=15, nasal step, n=30, paracentral, n=17) were most strongly associated with temporal and temporal–superior RNFL sectors (P = 0.02). ROC curve areas for discrimination between different patterns of VF loss and normal controls ranged from 0.73 to 0.98. Furthermore, GDx VCC could discriminate between normal VF hemifields in glaucoma patients and VF hemifields in normal controls (ROC curve area = 0.81 superior VF hemifield, 0.73 inferior VF hemifield). Conclusions: The RNFL in the specific sectors of the parapapillary retina was topographically related to patterns of visual field loss. GDx VCC can differentiate between apparently normal VF hemifields in glaucoma patients and VF hemifields in normal controls.
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