title: Enhanced structure-function relationship in glaucoma with an anatomically and geometrically accurate neuroretinal rim measurement.
abstract: OBJECTIVE
  To evaluate the structure-function relationship between disc margin-based rim area (DM-RA) obtained with confocal scanning laser tomography (CSLT), Bruch's membrane opening-based horizontal rim width (BMO-HRW), minimum rim width (BMO-MRW), peripapillary retinal nerve fiber layer thickness (RNFLT) obtained with spectral-domain optical coherence tomography (SD-OCT), and visual field sensitivity.
  
  
  METHODS
  We examined 151 glaucoma patients with CSLT, SD-OCT, and standard automated perimetry on the same day. Optic nerve head (ONH) and RNFL with SD-OCT were acquired relative to a fixed coordinate system (acquired image frame [AIF]) and to the eye-specific fovea-BMO center (FoBMO) axis. Visual field locations were mapped to ONH and RNFL sectors with fixed Garway-Heath (VF(GH)) and patient-specific (VF(PS)) maps customized for various biometric parameters.
  
  
  RESULTS
  Globally and sectorally, the structure-function relationships between DM-RA and VF(GH), BMO-HRW(AIF) and VF(GH), and BMO-HRW(FoBMO) and VF(PS) were equally weak. The R(2) for the relationship between DM-RA and VF(GH) ranged from 0.1% (inferonasal) to 11% (superotemporal) whereas that between BMO-HRW(AIF) and VF(GH) ranged from 0.1% (nasal) to 10% (superotemporal). Relatively stronger global and sectoral structure-function relationships with BMO-MRW(AIF) and with BMO-MRW(FoBMO) were obtained. The R(2) between BMO-MRW(AIF) and VF(GH) ranged from 5% (nasal) to 30% (superotemporal), whereas that between BMO-MRW(FoBMO) and VF(PS) ranged from 5% (nasal) to 25% (inferotemporal). The structure-function relationship with RNFLT was not significantly different from that with BMO-MRW, regardless of image acquisition method.
  
  
  CONCLUSIONS
  The structure-function relationship was enhanced with BMO-MRW compared with the other neuroretinal rim measurements, due mainly to its geometrically accurate properties.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Dalhousie University and Capital Health District Authority, Halifax, Nova Scotia, Canada.
authors.forename: Vishva M
authors.initials: VM
authors.lastname: Danthurebandara
authors.affiliation: Department of Ophthalmology and Visual Sciences, Dalhousie University and Capital Health District Authority, Halifax, Nova Scotia, Canada.
authors.forename: Glen P
authors.initials: GP
authors.lastname: Sharpe
authors.affiliation: Department of Ophthalmology and Visual Sciences, Dalhousie University and Capital Health District Authority, Halifax, Nova Scotia, Canada.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Hutchison
authors.affiliation: Department of Optometry and Vision Sciences, University of Melbourne, Victoria, Australia Department of Computing and Information Systems, University of Melbourne, Victoria, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Denniss
authors.affiliation: Department of Ophthalmology and Visual Sciences, Dalhousie University and Capital Health District Authority, Halifax, Nova Scotia, Canada.
authors.forename: Marcelo T
authors.initials: MT
authors.lastname: Nicolela
authors.affiliation: Department of Optometry and Vision Sciences, University of Melbourne, Victoria, Australia.
authors.forename: Allison M
authors.initials: AM
authors.lastname: McKendrick
authors.affiliation: Department of Computing and Information Systems, University of Melbourne, Victoria, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Turpin
authors.affiliation: Department of Ophthalmology and Visual Sciences, Dalhousie University and Capital Health District Authority, Halifax, Nova Scotia, Canada.
authors.forename: Balwantray C
authors.initials: BC
authors.lastname: Chauhan
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D058609:Visual Field Tests; D014794:Visual Fields
keywords: automated perimetry; glaucoma; optic nerve head; structure–function relationship; visual field