Badlani Vandana, Shahidi Mahnaz, Shakoor Akbar, Edward Deepak P, Zelkha Ruth, Wilensky Jacob
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 60612, USA.
J Glaucoma. 2006 Aug;15(4):275-80. doi: 10.1097/01.ijg.0000212298.23787.bf.
To investigate the presence of retinal nerve fiber layer (RNFL) thinning and determine the relationship between RNFL thickness and visual field sensitivity loss in glaucoma patients with asymmetric hemifield visual field loss.
Thirty glaucoma patients with asymmetric hemifield visual field loss and 30 normal control subjects were included in the study. RNFL thickness was measured by optical coherence tomography and visual field sensitivity was measured by automated perimetry. Glaucoma patients with advanced visual field loss restricted to 1 hemifield and early or absent glaucomatous field loss in the other hemifield on the basis of the visual field data were included. Visual field sensitivity and mean deviation (MD) were averaged separately in each of the 2 hemifields. The hemifields in each eye were categorized as early (MD>or=-6 dB) and advanced (MD<-6 dB) glaucomatous hemifields.
RNFL thickness measurements in corresponding (eg, superior peripapillary quadrant with inferior hemifield) advanced glaucomatous hemifields (59+/-16 microm) were significantly (P<0.001) lower than in corresponding early glaucomatous hemifields (90+/-25 microm). The mean RNFL thickness in corresponding advanced and early glaucomatous hemifields were significantly lower than in normal control subjects (P<0.0001). On the basis of the normative database supplied by optical coherence tomography software, 100% and 43% of eyes had abnormal RNFL thickness in corresponding advanced and early glaucomatous hemifields, respectively. A linear correlation was found between RNFL thickness and MD in the early (r=0.6; P<0.001) and advanced (r=0.5; P=0.007) glaucomatous hemifields.
RNFL thinning was present in corresponding hemifields of glaucomatous eyes with minimal visual field defect and correlated with visual field sensitivity loss. Measurement of RNFL thickness has potential for detection of early nerve fiber loss owing to glaucoma.
研究青光眼患者不对称半视野视野缺损时视网膜神经纤维层（RNFL）变薄情况，并确定RNFL厚度与视野敏感度丧失之间的关系。
本研究纳入30例不对称半视野视野缺损的青光眼患者和30例正常对照者。采用光学相干断层扫描测量RNFL厚度，采用自动视野计测量视野敏感度。根据视野数据，纳入视野缺损局限于一个半视野且晚期视野缺损，而另一个半视野早期或无青光眼性视野缺损的青光眼患者。分别计算每只眼睛两个半视野的视野敏感度和平均偏差（MD）。每只眼睛的半视野分为早期（MD≥-6 dB）和晚期（MD＜-6 dB）青光眼性半视野。
相应的（如，视乳头周围上象限与下半视野）晚期青光眼性半视野的RNFL厚度测量值（59±16μm）显著低于（P＜0.001）相应早期青光眼性半视野（90±25μm）。相应晚期和早期青光眼性半视野中的平均RNFL厚度显著低于正常对照者（P＜0.0001）。根据光学相干断层扫描软件提供的标准数据库，相应晚期和早期青光眼性半视野中分别有100%和43%的眼睛RNFL厚度异常。在早期（r=0.6；P＜0.001）和晚期（r=0.5；P=0.007）青光眼性半视野中，RNFL厚度与MD之间存在线性相关性。
在视野缺损最小的青光眼患者相应半视野中存在RNFL变薄，且与视野敏感度丧失相关。测量RNFL厚度有潜力检测青光眼导致的早期神经纤维损失。
