Association of retinal vessel caliber and visual field defects in glaucoma.
OBJECTIVE
This study evaluates the asymmetry of peripapillary retinal vessel caliber between inferior and superior hemispheres in eyes with visual field defects predominantly in one hemifield.


METHODS
Observational case series.


METHODS
In a retrospective study, 64 eyes of 64 patients with primary open-angle glaucoma who had a marked difference in visual field defects between hemifields and who had no history of diabetes, trauma, or vascular occlusive disease were studied. The diameters of the superior and inferotemporal vessels were measured at the optic disk border with calipers on an enlarged image.


RESULTS
In 64 eyes, the average ratio of the superior temporal artery diameter to inferotemporal artery diameter was significantly greater in the eyes with predominantly superior visual field defects as compared with those with inferior defects (1.10 +/- 0.22 vs. 0.92 +/- 0.19, respectively, P =.002, two-tailed t test). This indicates that the arteriole corresponding to the hemifield with the greater visual field defect was narrower than the arteriole in the other hemifield. This relationship was confirmed using chi(2) analysis (P =.002) comparing the proportions of eyes with ratios greater or less than normal vessel caliber ratios (normal ratio = 0.95 from data reported by Jonas and associates to the location of the dominant field defect. No statistically significant relationship was detected between retinal vein diameter and localized visual field defects, as determined by both the unpaired t test and chi(2) analysis.


CONCLUSIONS
In eyes with primary open-angle glaucoma, this study demonstrates a strong association between decreased peripapillary arteriole diameter and visual field defects in the corresponding hemifield. This reflects either an ischemic basis for glaucomatous damage or vascular constriction when there are fewer axons to nourish.
Hall
J K
JK
Scheie Eye Institute, University of Pennsylvania Health System, 51 North 39th Street, Philadelphia, PA 19104, USA.
Andrews
A P
AP
Walker
R
R
Piltz-Seymour
J R
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000473:pathology; D005260:Female; D005654:Fundus Oculi; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000098:blood supply; D010781:Photography; D012161:Retinal Artery / Q000473:pathology*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000175:diagnosis*; D014794:Visual Fields