PURPOSE

To evaluate an effective functional strategy for detecting glaucomatous damage of the macula in preperimetric to perimetric glaucoma.

DESIGN

Cross-sectional study.

METHODS

Preperimetric glaucoma patients (n = 102) and perimetric glaucoma patients (n = 88) with isolated paracentral scotoma or combined paracentral scotoma were enrolled in this study. Global and sectoral mean sensitivities (MS) were evaluated using 10-2 standard automated perimetry (SAP) with a stimulus of sizes III (0.43-degree diameter) and V (1.72 degrees), and 10-2 Matrix perimetry with a stimulus of 2 degrees. Ganglion cell-inner plexiform layer (GCIPL) was measured using spectral-domain optical coherence tomography.

RESULTS

The percentage of significantly depressed visual field (VF) points <5% and <1% in the pattern deviation plot was higher with frequency doubling technology (FDT) 10-2 than with SAP 10-2 III in patients with preperimetric glaucoma (both P < .001). Using FDT 10-2 tests, the global structure-function correlation was superior to SAP 10-2 (III or V) in both preperimetric and perimetric glaucoma. Topographic structure-function relationships for each VF test were more favorable with the FDT 10-2 test. The preperimetric glaucoma patients showing VF abnormalities on FDT 10-2 or SAP 10-2 (III) showed thinner average, minimum, superior, inferior, and inferotemporal GCIPL thicknesses than in those without VF abnormalities (all P < .05).

CONCLUSIONS

FDT 10-2 was found to detect functional damage of the macula early in preperimetric glaucoma, and to perform better than with SAP 10-2 (size III or V) from preperimetric to perimetric glaucoma in the structure-function relationship. FDT 10-2 can be considered a useful tool to detect glaucomatous damage of the macula early and appropriately.