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KMID : 1813520170060020039
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Journal of the Korean Glaucoma Society
2017 Volume.6 No. 2 p.39 ~ p.48
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Structure-function Relationship in Glaucoma Assessed Using Nasal Peripapillary Retinal Nerve Fiber Layer Thickness Measurements
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Yoo Eun-Joo
Yoo Chung-Kwon
Kim Yong-Yeon
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Abstract
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Purpose : To evaluate the structure-function relationships using the average retinal nerve fiber layer thickness (RNFLT) and the nasal RNFLT in primary open-angle glaucoma (OAG) patients.
Methods : This retrospective study included 283 OAG patients and 44 normal controls. The average RNFLT was defined as the mean of the 360° of peripapillary RNFLT, and the nasal RNFLT as the average of the peripapillary RNFLT from 1 o'clock to 5 o'clock directions. The structure-function relationships between the average or nasal RNFLT and the mean deviation (MD) of corresponding visual field (VF) were assessed by regression analyses. The R package named ‘segmented’ was used to investigate whether there was a statistically significant breakpoint.
Results : The relationship between the MD and the average RNFLT was better explained in glaucoma patients by a second-order polynomial regression model than a linear model (both p < 0.001, adjusted-R2 = 0.646 and R2 = 0.623, respectively). The MD value of ?16.29 dB was identified as the significant breakpoint. For the nasal RNFLT, a second-order polynomial model did not fit better than the linear model (both p < 0.001, adjusted-R2 = 0.209 and R2 = 0.381, respectively), with no statistically significant breakpoint.
Conclusions : The nasal RNFLT did not have a breakpoint but showed a continual decrease even at the advanced stage of glaucoma, whereas the average RNFLT had a breakpoint over which no further thinning could be observed despite further VF loss. These findings suggest the potential of the nasal peripapillary RNFLT as a useful marker to monitor the progression in advanced glaucoma.
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KEYWORD
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Retinal nerve fiber layer thickness, Open-angle glaucoma
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