Mapping structural damage of the optic disk to visual field defect in glaucoma.

PURPOSE

To evaluate the relation between the location of focal visual field defects and optic disk damage in eyes with glaucoma by short-wavelength automated perimetery and confocal scanning laser ophthalmoscopy.

METHODS

In 14 patients (14 eyes) with open-angle glaucoma, focal optic disk damage, and focal visual field loss, we obtain visual fields with short-wave-length automated perimetry. The short-wavelength automated perimetry visual field was divided into 21 zones, representing retinal nerve fiber layer arcuate bundles. Test points were compared with a normative database. The optic disk was assessed with a confocal scanning laser ophthalmoscope. Optic disk measurements were calculated in 10-degree sectors and compared with a normative database using a new measure, the rim area ratio, which adjusts for individual differences in disk size.

RESULTS

The mean number (+/-SD) of damaged visual field zones was 3.9 (+/-1.9), and the mean number of damaged rim sectors was 5.0 (+/-2.9). Focal defects on the optic disk and on short-wavelength automated perimetry were topographically related with specific damaged visual field zones corresponding to specific damaged rim sectors.

CONCLUSIONS

In patients with open-angle glaucoma with focal optic disk damage and focal visual field loss, defects in optic disk and short-wavelength automated perimetry are topographically related. The rim area ratio can be used to identify focal optic nerve defects.