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Abstract
Purpose: To investigate the association between macular inner retinal layer thickness and macula visual field (VF) mean deviation as measured by the Humphrey Field Analyzer (HFA) or macular function as measured by focal macular electroretinograms (ERGs) in patients with glaucoma.Methods: The participants in this cross-sectional study were 71 patients with glaucoma and 10 healthy controls. Macular inner retinal layer thickness and function were measured in all participants using optical coherence tomography (OCT) and HFA or focal macular ERGs, respectively. Macular OCT images were segmented into the macular retinal nerve fiber layer (mRNFL), macular ganglion cell layer/inner plexiform layer (GCL/IPL), and ganglion cell complex (GCC). Spearman correlation analysis was used to assess the relationship between macular inner retinal layer thickness and function.Results: Focal macular ERGs were composed of a negative wave (N1), a positive wave (P1), and a slow negative wave (N2). The N2 response density was significantly reduced in eyes with glaucoma, and was significantly associated with the thickness of the mRNFL (R = 0.317), GCL/IPL (R = 0.372), or GCC (R = 0.367). The observed structure–function relationship was also significantly correlated with the HFA VF mean deviation for each thickness [mRNFL (R = 0.728), GCL/IPL (R = 0.603), or GCC (R = 0.754)].Conclusions: Although a significant correlation was found between the N2 response density and the thickness of the macular inner layer, the observed structure–function relationship with the mean deviation of the HFA VF was higher than that of the N2 response density.
Highlights
Glaucoma is a group of ocular diseases known to be characterized by retinal ganglion cell (RGC) soma and axon loss [1, 2]
Disease grade in the glaucomatous eyes of the 71 patients, which was based on the standard visual field (VF) severity grading scale [14], ranged from early to moderate, with 13 (18.3%), 17 (23.9%), and 41 (57.7%) eyes classified as early, moderate, and severe, respectively
The structure–function relationship was evaluated based on the macular retinal nerve fiber layer (mRNFL), ganglion cell/inner plexiform layer (GCL/IPL), or ganglion cell complex (GCC) thickness and VF mean deviation
Summary
Glaucoma is a group of ocular diseases known to be characterized by retinal ganglion cell (RGC) soma and axon loss [1, 2]. Some studies investigated the relationship between local sensitivity loss on 10-2 visual field (VF) loss and macular ganglion cell/inner plexiform layer (GCL/IPL) thickness [4,5,6,7]. Clarifying the relationship between macular GCL/IPL thickness and central visual function could help clinicians gain a better understanding of how to detect glaucomatous damage at the early stage and disease progression. The amplitude of the focal PhNR has been shown to be significantly correlated with a reduction in both visual sensitivity as determined by standard automated perimetry (SAP) [11] and retinal nerve fiber layer (RNFL) thickness [10] in patients with glaucoma. Due to recent improvements in the mfERG technique, the pupil does not need to be dilated before recording the mfPhNR
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