title: Cone Integrity in Glaucoma: An Adaptive-Optics Scanning Laser Ophthalmoscopy Study.
abstract: OBJECTIVE
  To investigate photoreceptor changes in eyes with glaucoma.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The study included 35 eyes of 35 patients with primary open-angle glaucoma who had suffered parafoveal visual field loss at least 3 years previously, as well as 21 eyes of 21 normal subjects. Eyes with an axial length ≥26.0 mm were excluded. All subjects underwent a full ophthalmologic examination, including spectral-domain optical coherence tomography (SDOCT) and prototype adaptive-optics scanning laser ophthalmoscopy (AO-SLO) imaging.
  
  
  RESULTS
  As determined using AO-SLO, eyes with glaucoma did not differ significantly from normal eyes in terms of either cone density (26 468 ± 3392 cones/m2vs 26 147 ± 2700 cones/m2, respectively; P = .77; measured 0.5 mm from the foveal center) or cone spatial organization (ratio of hexagonal Voronoi domain: 43.7% ± 4.4% vs 44.3% ± 4.9%; P = .76; measured 0.5 mm from the foveal center). Furthermore, SDOCT showed that the 2 groups did not differ significantly in terms of the photoreceptor-related layer thickness, and that the photoreceptor ellipsoid zone band was continuous in all normal and glaucoma eyes. In glaucoma eyes with vertically asymmetric severity, the more affected side did not significantly differ from the less affected side in terms of cone density, cone spatial organization, or photoreceptor-related layer thickness. In 8 eyes (22.9%) with glaucoma, dark, partition-like areas surrounded the cones on the AO-SLO.
  
  
  CONCLUSIONS
  Both AO-SLO and SDOCT showed cone integrity in eyes with glaucoma, even in areas with visual field and nerve fiber loss. In AO-SLO, microcystic lesions in the inner nuclear layer may influence images of the cone mosaic.
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Tomoko
authors: T
authors: Hasegawa
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: ohoto@kuhp.kyoto-u.ac.jp.
authors: Sotaro
authors: S
authors: Ooto
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Kohei
authors: K
authors: Takayama
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Yukiko
authors: Y
authors: Makiyama
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Tadamichi
authors: T
authors: Akagi
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Hanako O
authors: HO
authors: Ikeda
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Hideo
authors: H
authors: Nakanishi
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Kenji
authors: K
authors: Suda
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Hiroshi
authors: H
authors: Yamada
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Akihito
authors: A
authors: Uji
authors: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Nagahisa
authors: N
authors: Yoshimura
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000000981:diagnostic imaging*; D005654:Fundus Oculi; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009887:Ophthalmoscopy / Q000379:methods / Q000401:mortality*; D055095:Optics and Photonics; D015203:Reproducibility of Results; D017949:Retinal Cone Photoreceptor Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity