Characteristics of Normal-tension Glaucoma Patients with Temporal Retinal Nerve Fibre Defects

Hae Ri Yum,Chan Kee Park,Hae-Young Lopilly Park

doi:10.1038/s41598-020-63486-7

Hae Ri Yum, Chan Kee Park + Show 1 more

Open Access

https://doi.org/10.1038/s41598-020-63486-7

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Abstract

Glaucomatous visual field (VF) damage usually involves in the Bjerrum area, which refers to outside the central 10° region. However, some reports suggest that structural damage to the macula occurs even in the early stages of glaucoma. We investigated the characteristics of normal tension glaucoma (NTG) patients with temporal retinal nerve fibre layer (RNFL) defects. Ninety eyes from 90 subjects including 30 normal eyes, 30 eyes of 30 patients with normal-tension glaucoma with temporal RNFL defects, and 30 eyes of 30 patients with normal-tension glaucoma with inferotemporal or superotemporal RNFL defects were enrolled. The best-corrected visual acuity (BCVA) decreased significantly in glaucomatous eyes with temporal RNFL defects as compared with in controls and glaucomatous eyes with inferotemporal or superotemporal RNFL defects. VF tests showed more frequent central or cecocentral VF defects involving the central 10° region in glaucomatous eyes with temporal RNFL defects. VF defects were more frequently detected on short-wavelength automated perimetry (SWAP). Eyes with temporal RNFL defects had generally reduced ganglion cell-inner plexiform layer (GCIPL) thickness. In addition, the BCVA, GCIPL thicknesses, and SWAP findings were significantly different in glaucoma patients with temporal RNFL defects according to their colour vision deficiency, not RNFL thickness or standard automated perimetry (SAP) results.

Highlights

Glaucoma is a major cause of blindness worldwide[1]
We assumed that normal-tension glaucoma (NTG) patients with temporal retinal nerve fibre layer (RNFL) defects may have apparent structural differences regarding optic nerve head (ONH) and visual field defects as compared with NTG patients with inferotemporal or superotemporal RNFL defects
An analysis was conducted to compare optic disc parameters and the RNFL thickness profile with macular ganglion cell analysis (GCA) maps determined by Cirrus high-definition optical coherence tomography (HD-OCT) and various visual field tests among normal controls, NTG patients with inferotemporal or superotemporal RNFL defects, and NTG patients with temporal RNFL defects

Summary

Introduction

Glaucoma is a major cause of blindness worldwide[1]. It is a neurodegenerative disorder characterized by a progressive loss of retinal ganglion cells (RGCs) and their axons. Some glaucoma patients have RNFL damage close to the central region in the retina, the temporal region of the optic disc, and present with paracentral or central scotoma in the visual field[2]. We assumed that normal-tension glaucoma (NTG) patients with temporal RNFL defects may have apparent structural differences regarding optic nerve head (ONH) and visual field defects as compared with NTG patients with inferotemporal or superotemporal RNFL defects. An analysis was conducted to compare optic disc parameters and the RNFL thickness profile with macular ganglion cell analysis (GCA) maps determined by Cirrus high-definition optical coherence tomography (HD-OCT) and various visual field tests among normal controls, NTG patients with inferotemporal or superotemporal RNFL defects, and NTG patients with temporal RNFL defects

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