Retinal nerve fibre thickness measured with optical coherence tomography accurately detects confirmed glaucomatous damage.
OBJECTIVE
To assess the accuracy of optical coherence tomography (OCT) in detecting damage to a hemifield, patients with hemifield defects confirmed on both static automated perimetry (SAP) and multifocal visual evoked potentials (mfVEP) were studied.


METHODS
Eyes of 40 patients with concomitant SAP and mfVEP glaucomatous loss and 25 controls underwent OCT retinal nerve fibre layer (RNFL), mfVEP and 24-2 SAP tests. For the mfVEP and 24-2 SAP, a hemifield was defined as abnormal based upon cluster criteria. On OCT, a hemifield was considered abnormal if one of the five clock hour sectors (3 and 9 o'clock excluded) was at <1% (red) or two were at <5% (yellow).


RESULTS
Seventy seven (43%) of the hemifields were abnormal on both mfVEP and SAP tests. The OCT was abnormal for 73 (95%) of these. Only 1 (1%) of the 100 hemifields of the controls was abnormal on OCT. Sensitivity/specificity (one eye per person) was 95/98%.


CONCLUSIONS
The OCT RNFL test accurately detects abnormal hemifields confirmed on both subjective and objective functional tests. Identifying abnormal hemifields with a criterion of 1 red (1%) or 2 yellow (5%) clock hours may prove useful in clinical practice.
Hood
D C
DC
Department of Psychology, 405 Schermerhorn, Columbia University, New York, NY 10027, USA. dch3@columbia.edu
Harizman
N
N
Kanadani
F N
FN
Grippo
T M
TM
Baharestani
S
S
Greenstein
V C
VC
Liebmann
J M
JM
Ritch
R
R
D000368:Aged; D005074:Evoked Potentials, Visual; D005901:Glaucoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields