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Sandy Steudel, Thomas Callan, Gary C Lee, Esther Young, Paul H. Artes, Michael Wall, John G Flanagan; Exploring the Structure-Function Relationship for Perimetry Stimulus Sizes III, V and VI and OCT in Early Glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):376.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate how perimetry stimulus size (Goldmann size III, V and VI) influences the structure-function correlation between visual field (VF) and OCT in patients with early glaucoma.
121 normal (48 male, 73 female, age range: 41 to 79 years) participants and 101 patients with early glaucoma (53 male, 48 female, age range: 43 to 81 years; MD Mean ± SD: -1.3 ± 1.3 dB) from three sites were tested. Subjects were included into the glaucoma group based on clinical diagnosis of glaucoma (treatment started), structural defect detected by OCT (Cirrus, Carl Zeiss Meditec, Dublin, CA; RNFL – a minimum of one quadrant yellow or two clock hours red; ONH – Rim Area or Vertical C/D yellow) and a VF MD of -4.0 dB or better (HFA SITA-Std, 24-2, HFA Model IIi 750, Carl Zeiss Meditec, Dublin, CA). For one eye per subject three visual field tests were obtained using the Full Threshold 24-2 for stimulus Size III, V and VI. Structure was assessed using the OCT with one Optic Disc 200x200 Cube scan and one Macular 200x200 Cube scan acquired per eye.Using the Pearson correlation coefficient, we compared the HFA mean sensitivity (MS) values of the three stimulus sizes to the OCT mean RNFL Thickness and the mean GCIPL Thickness (logarithmically transformed to dB units). We also compared visual field sensitivity and OCT RNFL thickness in the six sectors proposed by Garway-Heath (GH) for mapping structure and function  (Figure 1) for HFA threshold sensitivity and OCT RNFL thickness.
Correlation was similar for each stimulus size when compared to the structural data of the OCT. HFA mean sensitivity (MS) in normal and early glaucoma subjects correlated well with RNFL mean thickness, GCIPL mean thickness, as well as the Garway-Heath sectors 2 and 4 (Table 1).
Using the Goldmann stimulus Size V and VI in threshold testing did not significantly change the structure-function relationship when compared to standard stimulus Size III in this study of patients with early glaucoma. Garway-Heath, D.F. et al., 2000. Mapping the visual field to the optic disc in normal tension glaucoma eyes. Ophthalmology, 107 (10), pp.1809–15.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Table 1. Pearson correlation coefficient (r) for VF vs. OCT comparisons, with 95% confidence interval
Figure 1. Visual field and Optic Nerve Head sectors according to Garway-Heath 
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