Correlating Structure With Function in End-Stage Glaucoma

Abstract

<H4>BACKGROUND AND OBJECTIVE</H4> <P>To correlate structure and function in eyes with end-stage glaucoma.</P> <H4>PATIENTS AND METHODS</H4> <P>Fifty-six eyes of 48 patients with glaucoma presenting with end-stage glaucoma underwent scanning laser polarimetry (SLP) imaging using a commercially available GDxvariable corneal compensator unit (GDx-VCC; Laser Diagnostics Technologies, Inc., San Diego, CA). End-stage glaucoma was defined by both disc appearance and standard automated perimetry visual field criteria. Standard automated perimetry parameters included: mean deviation, pattern standard deviation, and total deviation plot. GDx parameters included: TSNIT average, superior average, inferior average, TSNIT standard deviation, and nerve fiber indicator.</P> <H4>RESULTS</H4> <P>The visual field mean deviation was -26.75 ± 3.50 dB. The remaining retinal nerve fiber layer measured in this group of eyes was: TSNIT average, 29.76 ± 5.81 µm; superior average, 30.76 ± 6.25 µm; and inferior average, 31.14 ± 7.20 µm. A low structure-function correlation was found when analyzing separately the superior and inferior hemifields (R<sup>2</sup> = 0.00001, R<sup>2</sup> = 0.0016, respectively).</P> <H4>CONCLUSIONS</H4> <P>In eyes with end-stage glaucoma, very thin but existing retinal nerve fiber layer is found on SLP. Such values rarely dropped below 10 to 20 µm. A flattening of the GDx TSNIT pattern was seen, and the correlation between structure and function was not evident.</P> <P>[<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2006;37:218-223.]</P> <H4>AUTHORS</H4> <P>From the Department of Ophthalmology (EZB, AH), Hebrew University-Hadassah Medical Center, Jerusalem, Israel; and the L. V. Prasad Eye Institute (RS, CG, AU, RT), Hyderabad, India.</P> <P>Accepted for publication October 21, 2005.</P> <P>Dr. Blumenthal has received research support from Laser Diagnostic Technologies, Inc., San Diego, CA.</P> <P>Address reprint requests to Eytan Z. Blumenthal, MD, Department of Ophthalmology, Hadassah University Hospital, P. O. Box 12000, Jerusalem 91120, Israel.</P>