PATTERN OF RETINAL NERVE FIBER LAYER DAMAGE IN EYES WITH NORMAL-TENSION GLAUCOMA AND HEMIFIELD VISUAL FIELD DOMINANT VISUAL FIELD DEFECT

M. S. Kook, K. R. Sung, R. H. Park, K. R Kim, S. T. Kim and W. Kang

Department of Ophthalmology, Asan Medical Center, Korea

Purpose: To evaluate quantitatively pattern of retinal nerve fiber layer(RNFL(change in eyes with normal-tension glaucoma(NTG)with hemifield dominant visual field defects using scanning laser polarimetry (GDx: Laser Diagnostic Technologies, San Diego, CA, USA)

Methods: Prospectively, Forty consecutive eyes from forty patients with NTG and hemifield visual field defect based on the Humphrey visual field underwent RNFL thickness measurements.Twenty normal eyes from twenty subjects matched in age and refractive error were selected as a control group.

Results: Symmetry, calculated as the ratio of superior to inferior RNFL thickness showed no statistical difference

between the study and control group(p=0.50). Affected ratio, calculated as the ratio of RNFL thickness in the quadrant corresponding to hemifield of visual field defect to that of temporal quadrant was statistically less than that of control.(p=0.00). Similar finding was noted in the unaffected ratio. However, overall, 27.5%(11/40 eyes) showed abnormal symmetry index that indicated focal RNFL change.

Conclusion: Despite a mixture of both focal and diffuse RNFL changes, symmetrical change in both upper and lower quadrants were prevalent. More sensitive parameters may be needed to detect focal RNFL change with GDx NFA.