Paracentral scotoma in glaucoma detected by 10-2 but not by 24-2 perimetry.
OBJECTIVE
To describe, in glaucomatous patients, spectral-domain optical coherence tomography (SD-OCT) results predictive of paracentral visual field (VF) defects present on standard automated perimetry (SAP) 10-2, but not on SAP 24-2.


METHODS
The SAP 10-2 test was repeated 3 times to determine whether paracentral VF defects were present. Spectralis™ HRA + OCT was used to obtain speckle-noise-reduced macular B-scans. The macular scan protocol consisted of 19 vertical cross-sectional scan lines centered on the fovea (30° × 15° volume scan), each of which was the average of 50 scans. A 3D OCT-2000 was also used to determine macular layer thicknesses and to detect abnormally thin regions (below the 1 % confidence interval of the normative data).


RESULTS
We identified 3 cases in which paracentral VF defects were detected on SAP 10-2, but not on SAP 24-2. Paracentral VF defects were detected on all of the SAP 10-2 tests repeated 3 times, and included absolute scotoma in 2 of the 3 SAP 10-2 results. Retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) damage was diminished on SD-OCT macular images; 2 patients had RNFL and GCL thinning within and central to the parafoveal region, where the GCL is generally thickest in healthy eyes, and 1 patient had evident RNFL and GCL thinning in the papillomacular bundle.


CONCLUSIONS
Macular SD-OCT scans may be useful in deciding whether SAP 10-2 should be performed.
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan, hangai@kuhp.kyoto-u.ac.jp.
Masanori
M
Hangai
Hanako Ohashi
HO
Ikeda
Tadamichi
T
Akagi
Nagahisa
N
Yoshimura
D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D057066:Low Tension Glaucoma / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D012165:Retinal Ganglion Cells / Q000473:pathology; D012607:Scotoma / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields