Pattern of retinal nerve fiber layer damage in Korean eyes with normal-tension glaucoma and hemifield visual field defect.
OBJECTIVE
To evaluate quantitatively the pattern of retinal nerve fiber layer (RNFL) damage in eyes with normal-tension glaucoma (NTG) with hemifield dominant visual field defects using scanning laser polarimetry.


METHODS
Prospectively, 40 consecutive eyes from 40 patients with NTG and hemifield defect based on the findings of examination using the Humphrey Field Analyzer underwent RNFL thickness measurements. Twenty normal eyes from 20 subjects matched in age and refractive error formed a control group.


RESULTS
Symmetry, calculated as the ratio of superior to inferior RNFL thickness, showed no statistically significant difference between the study group and the control group ( P=0.50). Overall, 27.5% (11/40 eyes) showed an "abnormal" symmetry index that indicated focal RNFL change. The affected ratio, calculated as the ratio of RNFL thickness in the quadrant corresponding to the hemifield of visual field defect to that of the temporal quadrant was significantly lower in the study group than in the control group ( P<0.0001). A similar finding was noted for the unaffected ratio.


CONCLUSIONS
Despite strict selection of the eyes with visual field defect confined to one hemifield, a mixture of both focal and diffuse RNFL damage was noted, with a common occurrence of symmetrical RNFL thinning in both upper and lower quadrants based on scanning laser polarimetry.
Kook
Michael S
MS
Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, 388-1 Pungnapdong, Songpa-gu, 138-736 Seoul, Korea. mskook@www.amc.seoul.kr
Lee
Sang-Un
SU
Sung
Kyung-Rim
KR
Tchah
Hungwon
H
Kim
Soon-Tae
ST
Kim
Kyung-Rhee
KR
Kang
Weechang
W
D000328:Adult; D000368:Aged; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006423:Hemianopsia / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009900:Optic Nerve / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D058609:Visual Field Tests; D014794:Visual Fields