Structure-function relationship in glaucoma: Optical coherence tomography en face imaging vs. red-free fundus photography

• Published in: Eye (London) Vol. 37; no. 14; pp. 2969 - 2976
• Main Authors: Bak, Eunoo, Choi, Hyuk Jin
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.10.2023; Nature Publishing Group
• Subjects: 692/698/1688/512; 692/699/3161/3172; Eye; Face; Glaucoma; Glaucoma - diagnosis; Humans; Intraocular Pressure; Laboratory Medicine; Medicine; Medicine & Public Health; Ophthalmology; Optic Disk; Optic Nerve Diseases; Pharmaceutical Sciences/Technology; Photography; Photography - methods; Structure-Activity Relationship; Structure-function relationships; Surgery; Surgical Oncology; Tomography; Tomography, Optical Coherence - methods; Visual field
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-023-02452-9

Background/Objectives To analyse retinal nerve fibre layer (RNFL) defect measurements obtained from red-free fundus photography and optical coherence tomography (OCT) en face imaging, respectively, and to compare them for the strength of the structure–function association. Subjects/Methods Two hundred and fifty-six glaucomatous eyes of 256 patients with localized RNFL defect on red-free fundus photography were enrolled. A subgroup analysis included 81 highly myopic eyes (≤ –6.0 dioptres). Angular width of RNFL defect was compared between red-free fundus photography (i.e., red-free RNFL defect) and OCT en face imaging (i.e., en face RNFL defect). The correlation between angular width of each RNFL defect and functional outcomes, reported as mean deviation (MD) and pattern standard deviation (PSD), were assessed and compared. Results The angular width of en face RNFL defect was measured smaller than that of red-free RNFL defect in 91.0% eyes (mean difference, 19.98°). The association of en face RNFL defect with MD and PSD was stronger ( R 2  = 0.311 and R 2  = 0.372, respectively) than that of red-free RNFL defect with MD and PSD ( R 2  = 0.162 and R 2  = 0.137, respectively) ( P  < 0.05 for all). Especially in highly myopic eyes, the association of en face RNFL defect with MD and PSD was much stronger ( R 2  = 0.503 and R 2  = 0.555, respectively) than that of red-free RNFL defect with MD and PSD ( R 2  = 0.216 and R 2  = 0.166, respectively) (P  < 0.05 for all). Conclusions En face RNFL defect showed a higher correlation with severity of visual field loss than did red-free RNFL defect. The same dynamic was observed for highly myopic eyes.