Macular thickness changes in glaucomatous optic neuropathy detected using optical coherence tomography.
OBJECTIVE
To correlate macular thickness and retinal nerve fiber layer (RNFL) thickness in normal and glaucomatous eyes using optical coherence tomography.


METHODS
Complete examination, automated achromatic perimetry, and optical coherence tomography of the peripapillary RNFL and macula were performed. Exclusion criteria were visual acuity of less than 20/40, diseases other than glaucoma, and unreliable automated achromatic perimetry. Macular thickness measurements were generated using 6 radial optical coherence tomographic scans (5.9 mm) centered on the fovea, and mean and quadrantic macular thickness values were calculated.


RESULTS
Fifty-nine eyes of 59 patients (29 normal and 30 glaucomatous) were enrolled (mean +/- SD age, 56.7 +/- 20.3 years; range, 20-91 years). All eyes with glaucoma had associated visual field loss (mean +/- SD mean defect, -8.4 +/- 5.8 dB). Mean macular thickness was significantly associated with visual field mean defect (R2 = 0.47; P<.001), pattern standard deviation (R2 = 0.32; P<.001), and mean RNFL thickness (R2 = 0.38; P<.001). In glaucomatous eyes with visual field loss localized to 1 hemifield (n = 11), mean +/- SD macular thickness in the quadrant associated with the field defect (277 +/- 28 micro m) was significantly less (P =.005) than in the unaffected quadrant (286 +/- 27 micro m). Mean RNFL thickness in the affected quadrant (89 +/- 53 micro m) was significantly thinner (P =.009) than in the unaffected quadrant (121 +/- 39 micro m).


METHODS
Mean total and quadrantic macular and RNFL thickness measurements.


CONCLUSIONS
Macular thickness changes are well correlated with changes in visual function and RNFL structure in glaucoma and may be a surrogate indicator of retinal ganglion cell loss.
Greenfield
David S
DS
Department of Ophthalmology, University of Miami School of Medicine, Bascom Palmer Eye Institute, 7108 Fairway Dr, Suite 340, Palm Beach Gardens, FL 33418, USA. dgreenfield@med.miami.edu
Bagga
Harmohina
H
Knighton
Robert W
RW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007368:Interferometry; D007429:Intraocular Pressure; D008027:Light; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D014054:Tomography / Q000379:methods; D014792:Visual Acuity; D014794:Visual Fields