Reyes R D, Tomita G, Kitazawa Y
Department of Ophthalmology, Gifu University School of Medicine, Japan.
J Glaucoma. 1998 Oct;7(5):329-35.
To evaluate changes in nerve fiber layer (NFL) thickness in areas with apparently normal retinal sensitivity in eyes with normal-tension glaucoma (NTG) with hemifield dominant visual field defects.
The prospective clinical study consisted of 17 eyes from 17 patients with NTG in whom superior or inferior hemifield dominant defects based on the Humphrey visual field of central 30 degrees were present, and 10 normal eyes from 10 control subjects matched in age and refractive error. The retinal NFL thickness was evaluated with a scanning laser polarimeter. Mean NFL thickness measurements in the defined ring in four quadrants (superior, inferior, nasal, and temporal) were obtained. To facilitate visual field and NFL thickness correspondence, the total deviation (TD) plot of the visual field was divided into four 90 degrees quadrants, using Wirtschafter's scheme to match the four quadrants examined by laser polarimetry.
The mean NFL thickness in the unaffected quadrant, i.e., the quadrant within the area corresponding to the hemifield with apparently normal visual field in eyes with NTG, was significantly thinner than the average NFL thickness of the superior and inferior quadrants in the normal eyes. In eyes with NTG, the NFL thickness in the affected quadrant also was significantly thinner than that in the unaffected quadrant. In the unaffected quadrant, visual field TD (the sum of the TD values within this quadrant) showed a significant correlation with the ratio of NFL thickness in the unaffected quadrant to that in the nasal quadrant.
Early changes in the retinal nerve fiber layer may already exist even in the unaffected area of the visual field in eyes with NTG with hemifield dominant visual field defects.
评估正常眼压性青光眼（NTG）伴半侧视野优势性视野缺损患者中，视网膜敏感度看似正常区域的神经纤维层（NFL）厚度变化。
这项前瞻性临床研究纳入了17例NTG患者的17只眼，这些患者基于中心30度 Humphrey视野存在上半侧或下半侧视野优势性缺损，以及10例年龄和屈光不正相匹配的对照受试者的10只正常眼。使用扫描激光偏振仪评估视网膜NFL厚度。获取四个象限（上、下、鼻侧和颞侧）中定义环内的平均NFL厚度测量值。为便于视野与NFL厚度对应，采用Wirtschafter方案将视野的总偏差（TD）图分为四个90度象限，以匹配激光偏振仪检查的四个象限。
在NTG患者眼中，未受影响象限（即与视野半侧中视野看似正常区域相对应的象限）的平均NFL厚度明显薄于正常眼中上象限和下象限的平均NFL厚度。在NTG患者眼中，受影响象限的NFL厚度也明显薄于未受影响象限。在未受影响象限中，视野TD（该象限内TD值之和）与未受影响象限与鼻侧象限的NFL厚度比值呈显著相关性。
在NTG伴半侧视野优势性视野缺损的眼中，即使在视野未受影响区域，视网膜神经纤维层可能也已存在早期变化。
