Relationship between patterns of visual field loss and retinal nerve fiber layer thickness measurements

PURPOSE: To investigate the association between pat. terns of visual field (VF) loss and retinal nerve fiber layer (RNFL) thickness measurements. DESIGN: Observational cross,sectional study. METHODS: One hundred twenty-one glaucoma patients and 65 healthy subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were included. All glaucoma patients had repeatable abnormal VFs and scanning laser polarimetry (SLP) RNFL thickness measurements. RNFL measurements were obtained from 16 equal parapapillary sectors. Patterns of VF loss were classified as arcuate, partial arcuate, nasal step, or paracentral in each VF hemifield. Logistic regression analysis was performed to determine which RNFL sectors were associated with each VF pattern. The ability of SLP to discriminate between eyes with different VF patterns and healthy eyes using receiver operating characteristic (ROC) curve analyses also was investigated. RESULTS: VF patterns in the superior hemifield were significantly associated with RNFL sectors in the temporal inferior hemiretina (P <.05). ROC curve areas for discrimination between eyes with different VF patterns and healthy eyes ranged from 0.85 to 0.95. VF patterns in the inferior hernifield were most strongly associated with temporal superior RNFL sectors (P <.05). ROC curve areas for discrimination between different VF patterns and healthy eyes ranged from 0.73 to 0.98. SLP could discriminate between apparently unaffected VF hemifields in glaucoma eyes and VF hemifields in healthy eyes. CONCLUSIONS: Parapapillary RNFL thickness was topographically related to patterns of VF loss. SLP can differentiate between apparently unaffected VF hemi, fields in glaucoma eyes and normal VF hemifields in healthyeyes.