Introduction: To determine the structure-function correlations of glaucoma in Filipinos using the average peripapillary retinal nerve fiber layer (RNFL) thickness and rim area (RA) of the spectral-domain optical coherence tomography (SD-OCT) and mean defect (MD), pattern standard deviation (PSD), and visual field (VF) clusters of standard automated perimetry (SAP) Methods: Consecutive tests consisting of SD-OCT, SAP, and disc photos were reviewed and selected based on abnormalities in VFs or OCTs or both. Each set of tests was classified as to VF defect type and severity. Mean threshold of VF clusters, MD, and PSD were correlated with average and sectoral RNFL thicknesses and RA. Results: One hundred eighty-six (168) eyes of 121 patients with mean age of 60.2 ± 14.7 years had an average MD, PSD, RNFL thickness, RA of -9.5 ± 8.5 dB, 5.4 ± 3.3 dB, 75.9 ± 15.9 μm, and 0.9 ± 0.4 mm2, respectively. Among VF tests, 23.1% were normal, 16.5% had early, 9.1% moderate, 12.4% advanced, and 8.3% severe glaucoma damage. Most common VF defect types were central islands, combined, and paracentral (16.5%, 14.4%, and 12.2%, respectively). The most commonly affected RNFL segments were inferior, followed by superior, and combined superior and inferior (51.2%, 47.1, and 34%, respectively). Among the OCT parameters, RNFL thickness and RA were strongly correlated (p<0.0001). Between the VF and OCT parameters, the strongest correlation was between the clusters of superior VF defects and the 6-8 o’clock RNFL thinning, followed by the inferior VF defects and the 12-1 o’clock RNFL thinning. Inferior RNFL thinning was strongly correlated with MD and PSD. Conclusion Among Filipino glaucomatous eyes monitored with SD-OCT and SAP, correlation was strongest between the superior VF defects and the infero-temporal RNFL thinning.
Visual Fields ; Tomography, Optical Coherence ; Glaucoma

PURPOSE: Recently, the introduction of spectral-domain optical coherence tomography (SD-OCT) has enabled measurement of retinal thickness in the posterior pole in 64 sectors. SD-OCT was used to evaluate the diagnostic effectiveness in detecting glaucomatous abnormality of visual field sensitivity. A normal value for retinal thickness was determined and then compared in corresponding local sectors. METHODS: Thirty healthy controls and 30 glaucoma subjects were evaluated. Macular thickness values from the 4 adjacent square cells in an 8 x 8 posterior pole retinal thickness map were averaged for a mean retinal thickness (MRT) value. A normative database was prepared using the data from the healthy eyes of this study to determine the diagnostic criteria for MRT. If the MRT value was <5% (Criteria A) or <1% (Criteria B) of the normative database, it was considered to be abnormal. The abnormalities of the MRT value for each diagnostic criteria were compared with the visual field sensitivity results in the corresponding positions. RESULTS: The concordance of abnormalities between MRT and visual field sensitivity at 16 measured points was low in both criteria A (Kappa value; -0.418~0.429) and B (Kappa value; -0.363~0.444). Based on the results of the visual field at each focal point, the sensitivities and specificities of MRT values using the 2 criteria ranged from 0% to 100%. CONCLUSIONS: In this study, MRT values showed low correlation and diagnostic ability to detect decreased sensitivity of the visual field in corresponding points, when customized criteria derived from a normative database were applied.
Glaucoma ; Reference Values ; Retinaldehyde* ; Tomography, Optical Coherence* ; Visual Fields

PURPOSE: To analyze the hyperacuity defects of preferential hyperacuity perimeter (PHP) in myopic CNV and correlate with the other macular anatomical or physiological properties obtained with fluorescein angiography (FA), Optical coherence Tomography (OCT), and central perimeter. METHODS: Seven patients with myopic CNV diagnosed by FA underwent PHP, OCT, central visual field (VF). We examined the locational correlation among FA, central VF and PHP hyperacuity defect and then compared PHP hyperacuity defect with the CNV size by OCT. Also we made a comparison with macular sensitivity change in VF and hyperacuity defects change in PHP after PDT in 4 patients. RESULTS: All the 7 eyes with myopic CNV tested positive for hyperacuity defects. 5 eyes showed locational correlation among PHP and FA, central VF. The size of hyperacuity defect of PHP and CNV size by OCT was positive correlation (p=0.007). Four eyes treated with PDT showed decrease of PHP hyperacuity defect size and changes in location according to decrease of CNV size after PDT. CONCLUSIONS: Our results suggest that the PHP may be used to detect myopic CNV and beneficial for analyzing functional effect following PDT in myopic CNV patients. These results require further validation in a larger population.
Fluorescein Angiography ; Humans ; Photochemotherapy ; Tomography, Optical Coherence ; Visual Fields

Objective: This study assessed the relationship of two structural tests, optic-disc photography and optical coherence tomography (OCT), and a functional test, standard achromatic perimetry (SAP), in the diagnosis of glaucoma. Methods: A retrospective review of charts from the database of a private glaucoma specialist and the glaucoma clinic of a tertiary hospital was done. The participants were longitudinally evaluated and had comprehensive eye examination, imaging, and functional testing. Optic-disc photographs, OCTs, and SAPs were interpreted and evaluated separately, and then correlated with each other by two glaucoma experts working individually. Sensitivities, specificities, and predictive values were obtained for each diagnostic test and in combination. Kappa statistics were used for interobserver agreement. Results: Three hundred sixty-seven eyes of 188 patients were included in the study. Fifty-eight patients were diagnosed as normal, 130 had glaucoma. OCT had the highest sensitivity and specificity at 70.7% and 76.6%, followed by SAP at 72.4% and 53.5% respectively. Optic-disc photos had the lowest sensitivity and specificity at 55.8% and 54.4% respectively, and the lowest interobserver agreement (kappa = 0.50-0.61). The predictive values of the 3 tests increased to 82% with good interobserver agreement (kappa = 0.68-0.78) when correlated with each other. Conclusion The correlation of structural and functional tests increased the accuracy of diagnosing glaucoma. These examinations offered complementary information and, when used in conjunction with comprehensive clinical evaluation, guided the clinician in the proper management of patients with glaucoma.
Glaucoma Optic Disk Tomography ; Optical Coherence Visual Fields

PURPOSE: To investigate the difference between superior and inferior peripapillary retinal nerve fiber layer (RNFL) thickness in early glaucoma patients who have RNFL defect in either superior quadrant or inferior quadrant and to determine if it can be useful to detect early glaucomatous change. METHODS: Eighty eight patients with early glaucoma who have RNFL defect in either the superior quadrant or the inferior quadrant as confirmed by red free photograph (40 eyes with normal standard automated perimetry and 48 eyes with early glaucomatous visual field loss) were divided into the superior RNFL defect group and the inferior RNFL defect group. The average RNFL thickness was measured in the superior and inferior quadrants using optical coherence tomography and the thickness differences between the superior and the inferior quadrants (S-I difference) were compared among early glaucoma eyes and 59 normal controls. Then, discriminative power of the S-I difference was assessed by area under ROC (AUROC). RESULTS: The average thickness of the RNFL showed a statistically significant difference between early glaucoma eyes and normal controls (P<0.05). S-I differences of the superior RNFL defect group and inferior RNFL defect group in preperimetric patients and in early perimetric patients were -20.5+/-16.4 micrometer and 15.0+/-14.2 micrometer, -24.0+/-17.2 micrometer and 18.4+/-16.7 micrometer, respectively, which were significantly greater than that of the normal control group (-8.2+/-17.1 micrometer). AUROC of S-I difference in the superior and inferior defect groups of preperimetric patients were 0.691, 0.872, respectively. CONCLUSIONS: The difference in RNFL thickness between the superior and inferior quadrants (S-I difference) in early glaucoma patients was larger than in normal controls. We expect that this parameter of RNFL analysis using OCT can be useful in detecting early glaucoma.
Eye ; Glaucoma ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields

PURPOSE: To evaluate the peripapillary retinal nerve fiber layer (RNFL) thickness with optical coherence tomography (OCT) in normal subjects and preperimetric glaucoma patients, as well as compare the results of OCT, short wavelength automated perimetry (SWAP), frequency doubling technology perimetry (FDT) in preperimetric glaucoma patients. METHODS: Thirty-six eyes of 36 preperimetric glaucoma patients who have definitive localized RNFL defects in disc photograph and normal standard visual field, as well as 35 eyes of 35 normal subjects, were enrolled in this study. We compared the peripapillary RNFL thickness between the two groups using Stratus OCT. Stratus OCT, FDT, and SWAP results in preperimetric glaucoma group were also compared. RESULTS: Compared with normal controls, peripapillary RNFL thickness, including the average, superior, and inferior quadrant, was significantly low (P<0.05) in the preperimetric glaucoma group, 93.40+/-11.16 micrometer, 118.33+/-21.17 micrometer, and 108.72+/-16.76 micrometer respectively. In preperimetric glaucoma group, functional and structural abnormalities were found in 55.6% with Stratus OCT, 31.4% with SWAP, and 79.4% with Matrix FDT. CONCLUSIONS: Statistically significant reduction of RNFL thickness was revealed in the preperimetric glaucoma group, and Matrix FDT was the most sensitive test for detecting early glaucomatous change, followed by Stratus OCT, and SWAP.
Glaucoma* ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields

PURPOSE: To compare the results of total deviation (TD) as measured by standard automated perimetry (SAP) and measured with of Matrix Frequency-doubling Technology (FDT) in patients with preperimetric glaucoma. METHODS: Fifty-two eyes of 52 patients with preperimetric glaucoma were included. Subjects were examined with Matrix FDT and Stratus optical coherence tomography (OCT), and the results of each examination were analyzed. The proportions of abnormal results in SAP TD, Matrix TD, and Matrix pattern deviation (PD) were calculated. Among the results of tests, the following correlations were evaluated: SAP TD and Matrix, and visual fields and OCT. In addition, the differences in peripapillary retinal nerve fiber layer thickness (RNFL) according to the result of SAP TD in preperimetric patients with abnormal Matrix PD were analyzed. RESULTS: A abnormalities in SAP TD, Matrix TD and Matrix PD were found in 22 (42.3%), 34 (65.4%), 41 (78.9%) eyes, respectively. There was marginal correlation between SAP TD and Matrix PD (p=0.07). No significant correlation was found between SAP TD and OCT, although Matrix PD and OCT did show significant correlation (p<0.05). In preperimetric patients with abnormal Matrix PD, RNFL thickness was significantly lower in the abnormal SAP TD group than in the normal SAP TD group on average, in the superior quadrant, and at the 12 o'clock and 5 o'clock positions (p<0.05). CONCLUSIONS: In patients with preperimetric glaucoma, 42.3% and 78.9% had glaucomatous VF defects in SAP TD and Matrix PD, respectively. These results were higher than expected, especially those of SAP TD.
Eye ; Glaucoma ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields

No abstract available.
Dengue/*complications ; Female ; Humans ; Tomography, Optical Coherence/*methods ; Vision Disorders/*diagnosis ; *Visual Acuity ; *Visual Fields

PURPOSE: To identify the correspondence between the central sensitivity of several visual field (VF) tests and ganglion cell inner plexiform layer (GC-IPL) thickness in early glaucoma patients with parafoveal scotoma. METHODS: Fifty-seven eyes from 57 patients with glaucomatous optic neuropathy and parafoveal scotoma were analyzed using the standard automated perimetry (SAP) C10-2 test, the SAP C24-2 test, and the frequency doubling technology perimetry (FDT) C24-2 test. The correlation between the VF central sensitivity and the GC-IPL thickness from macular scans via optical coherence tomography was analyzed. RESULTS: The central sensitivity was 27.51 ± 5.43 dB, 27.39 ± 5.05 dB, and 22.09 ± 5.08 dB for SAP C24-2, SAP C10-2, and FDT C24-2, respectively. Mean GC-IPL thickness was 70.2 ± 8.5 µm. Using regression analysis, the value of log R² between the logarithmic central sensitivity and GC-IPL thickness was 0.498, and the linear R2 between the antilogarithmic central sensitivity and GC-IPL thickness in SAP C10-2 was 0.486, and both were statistically significant (p < 0.05). This relationship was stronger in early glaucoma patients compared to late glaucoma patients using SAP C10-2. CONCLUSIONS: The structure-function relationship between GC-IPL thickness and central sensitivity was better with SAP C10-2, especially in early glaucoma patients, compared to other VF modalities.
Ganglion Cysts ; Glaucoma* ; Humans ; Optic Nerve Diseases ; Scotoma* ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields*

PURPOSE: Preferential hyperacuity perimeter (PHP) is a device that measures metamorphopsia in the central 14 degrees of the macular visual field which is presented by hyperacuity defect. We elucidated a hyperacuity defect lesion of PHP in exudative age-related macular degeneration (AMD) by Optical coherence tomography (OCT). METHODS: Nineteen eyes of 18 patients with exudative AMD diagnosed by fundus examination and fluorescein angiography (FA) underwent PHP. We then elucidated any hyperacuity defect lesion of PHP by fundus photography, FA and OCT. For a control, 20 eyes of 10 age-matched persons who had no ophthalmological abnormality underwent PHP and OCT to determine if hyperacuity defect would appear. RESULTS: Hyperacuity defect lesion appeared in 18 eyes (95%) of AMD patients. There was good locational correlation between the hyperacuity defect lesions and lesions in the fudoscopic examination in 16 eyes of 18, but there was a counterpart relation at the superior-inferior and left-right in 2 eyes. Hyperacuity defect lesion in PHP was of smooth or irregular elevation of the retinal pigment epithelium (RPE) in OCT. In the control, hyperacuity defect lesion appeared in 1 eye (5%) and it was normal in OCT. CONCLUSIONS: PHP showed a highly positive rate in detecting AMD-related lesion. The hyperacuity defects that are noted by the PHP are produced from elevation of the RPE.
Fluorescein Angiography ; Humans ; Macular Degeneration* ; Photography ; Retinal Pigment Epithelium ; Tomography, Optical Coherence ; Vision Disorders ; Visual Fields