Apport du GDx-VCC chez les patients hypertones oculaires : complémentarité avec la périmétrie bleu-jaune ou le FDT Matrix ?

Abstract

Evaluate the importance of GDx-VCC results compared with FDT Matrix and blue-on-yellow perimetry in a population of ocular hypertensive patients. Prospective study including 135 eyes of 135 patients. All had normal standard achromatic perimetry and intraocular pressure greater than 21 mmHg without medication. They underwent short wavelength automated perimetry (SWAP) 24-2 FASTPAC, FDT Matrix 24-2 Threshold strategy, and retinal nerve fiber layer (RNFL) analysis with GDx-VCC. Fifty two patients had neither structural (GDx-VCC) nor functional (SWAP and Matrix) optic nerve injury. Eighty-three patients had preperimetric glaucoma (at least one of the tests showed pathologic results). We found isolated functional defects (38% cases), isolated structural lesions (31% cases), or mixed injury (31% cases). When GDx-VCC revealed structural damage, Matrix was abnormal in 30%, as was SWAP in 8% of cases. Both functional and structural evaluation revealed identical defects for 12% of patients. RNFL loss could be either diffused or compatible with typical glaucomatous topography. Most temporal damage was detected by FDT Matrix, whereas SWAP performed better for nasal defects. The results of GDx analyses correlated better with Matrix than with SWAP. When associated with automated perimetry, GDx-VCC is a valuable tool to evaluate optic nerve damage and detect preperimetric glaucoma. Clinical evaluation of the optic nerve head remains essential. We found a good correlation between visual field defects and structural injuries.