Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
Division of Ophthalmology, Hospital Universitário Cassiano Antônio Moraes (HUCAM-EBSERH), Universidade Federal do Espírito Santo, Vitória, Brazil.
PLoS One. 2024 Mar 8;19(3):e0300103. doi: 10.1371/journal.pone.0300103. eCollection 2024.
To compare the relationship between macular ganglion cell layer (mGCL) thickness and 10-2 visual field (VF) sensitivity using different stimulus sizes in patients with temporal hemianopia from chiasmal compression.
A cross-sectional study was conducted involving 30 eyes from 25 patients with temporal VF loss on 24-2 SITA standard automated perimetry due to previous chiasmal compression and 30 healthy eyes (23 controls). Optical coherence tomography (OCT) of the macular area and 10-2 VF testing using Goldmann stimulus size I (GI), II (GII), and III (GIII) were performed in the Octopus 900 perimeter. For the sake of analysis, mGCL thickness and VF data were segregated into four quadrants (two temporal and two nasal) and two halves (temporal and nasal) centered on the fovea, in order to evaluate separately both the severely affected nasal hemi-retina corresponding to the temporal VF sectors and the subclinically affected temporal hemi-retina corresponding to the nasal VF sectors. Data from patients and controls were compared using generalized estimated equations. The discrimination ability of GI, GII, and GIII was evaluated, as was the correlation between mGCL and 10-2 VF sensitivity using GI, GII, and GIII.
All mGCL parameters in the nasal and temporal halves of the retina were significantly reduced in patients compared to controls. 10-2 VF test sensitivity using GI, GII, and GIII was significantly lower in patients than in controls (p≤0.008) for all parameters, except the three nasal divisions when using GI (p = 0.41, 0.07 and 0.18) Significant correlations were found between temporal VF sectors (all stimulus sizes) and the corresponding nasal mGCL measurements, with similar discrimination ability. Significant correlations were also observed between all three nasal VF divisions and the corresponding temporal mGCL thickness when using stimulus sizes I and II, but not stimulus size III.
On 10-2 VF testing, GII outperformed GI and GIII with regard to discrimination ability and structure-function correlation with mGCL thickness in the subclinically affected nasal part of the VF in patients with chiasmal compression. Our findings suggest that the use of GII can enhance the diagnostic power of 10-2 VF testing in early cases of chiasmal compression, although further studies are necessary to support this conclusion.
比较因视交叉压迫而导致颞侧视野（VF）损失的患者中，使用不同刺激大小的黄斑神经节细胞层（mGCL）厚度与 10-2VF 敏感性之间的关系。
本研究为横断面研究，共纳入 30 只眼，这些眼来自 25 例因视交叉压迫而导致 24-2SITA 标准自动视野计出现颞侧 VF 损失的患者和 30 只健康眼（23 例对照）。在 Octopus 900 周边视野计上进行黄斑区光学相干断层扫描（OCT）和 10-2VF Goldmann 刺激大小 I（GI）、II（GII）和 III（GIII）测试。为了进行分析，将 mGCL 厚度和 VF 数据按照以黄斑为中心的四个象限（两个颞侧和两个鼻侧）和两个半区（颞侧和鼻侧）进行了划分，以便分别评估与颞侧 VF 区域对应的严重受影响的鼻侧半视网膜和与鼻侧 VF 区域对应的亚临床受影响的颞侧半视网膜。使用广义估计方程比较患者和对照组的数据。评估了 GI、GII 和 GIII 的分辨能力，以及 GI、GII 和 GIII 与 mGCL 和 10-2VF 敏感性之间的相关性。
与对照组相比，患者的所有视网膜鼻侧和颞侧半区的 mGCL 参数均显著降低。除了使用 GI 时的三个鼻侧分区（p = 0.41、0.07 和 0.18）外，使用 GI、GII 和 GIII 时，患者的 10-2VF 测试敏感性均显著低于对照组（p≤0.008）。在所有刺激大小下，颞侧 VF 区域与相应的鼻侧 mGCL 测量值之间均存在显著相关性，且具有相似的分辨能力。当使用刺激大小 I 和 II 时，还观察到所有三个鼻侧 VF 分区与相应的颞侧 mGCL 厚度之间存在显著相关性，但刺激大小 III 除外。
在 10-2VF 测试中，与 GI 和 GIII 相比，GII 在视交叉压迫患者的亚临床受影响的鼻侧 VF 部分具有更好的分辨能力，与 mGCL 厚度的结构-功能相关性也更好。我们的研究结果表明，尽管还需要进一步的研究来支持这一结论，但在早期视交叉压迫病例中，使用 GII 可以提高 10-2VF 测试的诊断能力。
