Structure-Function Relationships in Perimetric Glaucoma: Comparison of Minimum-Rim Width and Retinal Nerve Fiber Layer Parameters

• Published in: Investigative ophthalmology & visual science Vol. 58; no. 11; pp. 4623 - 4631
• Main Authors: Amini, Navid, Daneshvar, Ramin, Sharifipour, Farideh, Romero, Pablo, Henry, Sharon, Caprioli, Joseph, Nouri-Mahdavi, Kouros
• Format: Journal Article
• Language: English
• Published: United States The Association for Research in Vision and Ophthalmology 01.09.2017
• Subjects: Aged; Bruch Membrane - pathology; Female; Glaucoma; Glaucoma, Open-Angle - diagnostic imaging; Glaucoma, Open-Angle - pathology; Humans; Male; Optic Disk - pathology; Retinal Neurons - pathology; Severity of Illness Index; Tomography, Optical Coherence; Visual Fields
• ISSN: 1552-5783; 0146-0404; 1552-5783
• DOI: 10.1167/iovs.17-21936

To test the hypotheses that: (1) structure-function (SF) relationships between visual fields (VF) and Bruch's membrane opening-based minimum rim width (BMO-MRW) measurements are superior to those for peripapillary retinal nerve fiber layer (pRNFL) in perimetric glaucoma; (2) BMO-MRW measurements may extend the utility of structural measurement across the range of glaucoma severity; and (3) to estimate the influence of Bruch's membrane opening (BMO) size on BMO-MRW measurements. One hundred eight perimetric glaucoma eyes (68 patients) with good quality spectral-domain optical coherence tomography images of the optic disc and pRNFL, and reliable VF within 6 months were recruited. Relationship of global and sectoral BMO-MRW and pRNFL thickness with corresponding VF parameters and the influence of normalizing BMO-MRW (on BMO circumference, nBMO-MRW) on SF relationships were investigated. Broken-stick models were used to compare the point at which pRNFL and BMO-MRW parameters reached their measurement floor. The median (interquartile range) of VF mean deviation was -5.9 (-12.6 to -3.6) dB. Spearman correlation coefficients between pRNFL, BMO-MRW, and nBMO-MRW measures and corresponding VF cluster average deviations ranged between 0.55 to 0.80, 0.35 to 0.66, and 0.38 to 0.65, respectively. Bruch's membrane opening-MRW parameters demonstrated weaker SF relationships compared with pRNFL globally and in temporal, temporal-superior, and nasal-inferior sectors (P < 0.03). Normalization of BMO-MRW did not significantly influence SF relationships. Structure-function relationships were somewhat weaker with BMO-MRW parameters compared with pRNFL in eyes with perimetric glaucoma. Bruch's membrane opening-MRW normalization did not significantly change SF relationships in this group of eyes with mild departures from average BMO size.