Association of optic disc configuration and clustered visual field sensitivity in glaucomatous eyes with hemifield visual field defects.

Purpose

To compare the morphologic alterations between upper and lower sectors of the optic nerve head (ONH) in eyes with primary open-angle glaucoma (POAG) that have hemifield visual field defects and to evaluate the correlation between this sectoral ONH damage and visual field sensitivity loss within the corresponding clustered test points of standard automated perimetry.

Methods

Visual field testing with Humphrey Field Analyzer and imaging with Heidelberg Retina Tomograph (HRT) were performed in 87 eyes from 87 Japanese patients with POAG and 150 eyes from 150 normal subjects. Global and segmental HRT topographic parameters were compared among POAG patients with superior hemifield defects, those with inferior hemifield defects, and controls. The correlation between the sectoral HRT measurements and the sum of total deviation values in the corresponding clustered visual field test points was analyzed in the 2 POAG groups.

Results

The HRT measurements in both POAG groups were significantly different from those of controls, not only in the sectors corresponding to abnormal hemifield, but also in the sectors corresponding to the normal visual hemifield. There was a linear correlation between the sectoral HRT parameters and clustered visual field sensitivities in the affected hemifield areas.

Conclusions

The present study indirectly supports the notion that the relationship between structural and functional damage of glaucomatous optic neuropathy is not linear when evaluated with the currently available techniques and instruments.