title: The relationship between macular cell layer thickness and visual function in different stages of glaucoma.
abstract: OBJECTIVE
  To determine whether there were differences in the structure-function relationship between early and advanced glaucoma, and study the association between thickness of discrete macular cell layers, the thickness of the retinal nerve fiber layer, and visual field sensitivity.
  
  
  METHODS
  In all, 71 eyes of 50 subjects (28 glaucoma patients and 22 normal control subjects) were included. Thickness of macular retinal nerve fiber layer (mRNFL), macular inner retinal layer (mIRL), and macular outer retinal layer (mORL) were measured from Stratus optical coherence tomography macular scans, using our previously published segmentation algorithm. Visual sensitivity loss was determined by mean deviation (MD) using Humphrey Visual Field Analyzer. The mean thickness for each layer from the normal control subjects, early, and advanced glaucoma groups was compared. In addition, a mixed model analysis was used to explore the relationship between structure-function, allowing for possible interaction with glaucoma stage.
  
  
  RESULTS
  The mean mRNFL thickness in early and advanced glaucoma patients was significantly less than measurements in normal subjects (P<0.01). The mean mIRL thickness in advanced glaucoma was significantly less than normal subjects (P=0.04). The mean mORL thickness in early and advanced glaucoma was not statistically significant different from that of normal subjects (P>0.8). There was no statistically significant difference in macular structure-function relationship between the two glaucoma groups (P>0.05). Mean mIRL thickness was significantly associated with MD (P=0.04).
  
  
  CONCLUSIONS
  There was no significant difference in macular structure-function relationship between early and advanced glaucoma groups. Combined data from both glaucoma groups indicated that mIRL thickness was associated with visual sensitivity loss.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 West Taylor Street, Chicago, IL 60612, USA. thasarat@uic.edu
authors.forename: T S
authors.initials: TS
authors.lastname: Vajaranant
authors.forename: R J
authors.initials: RJ
authors.lastname: Anderson
authors.forename: R
authors.initials: R
authors.lastname: Zelkha
authors.forename: C
authors.initials: C
authors.lastname: Zhang
authors.forename: J T
authors.initials: JT
authors.lastname: Wilensky
authors.forename: D P
authors.initials: DP
authors.lastname: Edward
authors.forename: M
authors.initials: M
authors.lastname: Shahidi
mesh_terms: D000368:Aged; D000465:Algorithms; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology