The relationship between retinal nerve fiber layer thickness and static visual fields in glaucoma

The authors studied the correlation between the thickness of the retinal nerve fiber layer (RNFL) and visual field loss in six eyes of six normal persons, seven eyes of seven patients with ocular hypertension, and 72 eyes of 46 patients with glaucoma. Peripapillary RNFL thickness was measured using optical coherence tomography. Mean deviation (MD) and mean sensitivity (MS) were obtained using program 24-2 of the Humphrey Field Analyzer. The relationships were nonlinear between RNFL thickness and whole field MD, and between RNFL thickness and whole field MS. The correlation between RNFL thickness and whole field MD for early glaucoma (MD ! -5 dB) was weaker than that for moderate or advanced glaucoma (MD < -5 dB). Similar relationships were obtained on hemifield analysis. In early-stage glaucoma, RNFL thickness in supero- and inferotemporal sectors was strongly correlated with the visual field in all sectors. This study shows that RNFL thickness is nonlinearly correlated with static visual fields in glaucoma. Sectorial division analysis of peripapillary RNFL thickness was effective in evaluating early glaucomatous visual fields.