Correlation of the Heidelberg Retinal Tomograph, Evaluation of the Retinal
Nerve Fiber Layer and Perimetry in the Diagnosis of Glaucoma
Skorkovská Š.1, Michálek J.2, Sedlačík M.3, Mašková Z.1, Kočí J.1
1Klinika nemocí očních a optometrie LF MU, Fakultní nemocnice U sv. Anny, Brno, přednosta doc. MUDr. S. Synek, CSc. 2 Katedra aplikované matematiky a informatiky, Ekonomicko-správní fakulta MU, Brno, vedoucí doc. ing. O. Vašíček, CSc. 3 Katedra ekonometrie, Univerzita obrany, Brno, vedoucí doc. RNDr. J. Moučka, PhD. |
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Summary:
Purpose: To assess the correlation of the selected structural and functional
methods in the diagnosis of glaucoma.
Methods: The study group (SG) of 40 patients with primary open angle
glaucoma with no or early visual field changes was compared to the control
group (CG) of 40 healthy persons of similar age in the first year of prospective
longitudinal study. All participants underwent the examination by means of
Heidelberg retinal tomograph, photography of retinal nerve fiber layer,
standard white-on-white perimetry, and blue-on-yellow perimetry. Only one eye
of each examined person was evaluated. Significance was assessed by means of
non-parametric test (Mann-Whitney) and the correlation analysis (Spearman)
was performed as well.
Results: No significant differences in age, visual acuity, and refraction between
SG and CG were found. The central corneal thickness (p< 0.05) and intraocular
pressure (p< 0.01) were significantly different between both groups. The visual
field mean sensitivity (MS) and mean defect (MD) of white-on-white perimetry
differ significantly between SG and CG comparing to the visual field
parameters of blue-on-yellow perimetry. HRT analysis found out significant
parameters: cup area (CA), cup/disc ratio (C/D), rim/disc ratio (R/D), and rim
volume (RV) (p< 0.05). Cup shape measure (CSM) and Mikelberg discrimination
function (FSM) were significant as well (p< 0.01). The loss of retinal nerve fiber
layer was significantly different (p< 0.01) between the glaucomatous and
healthy eyes. Spearman’s correlation analysis found out significant
correlations (MS and MD) only in blue-on-yellow perimetry and CV and RV of
HRT analysis by comparison of all healthy and glaucomatous eyes. Another
significant correlations were found by comparison of the retinal nerve fiber
layer loss to MS (p = 0.00) and MD (p = 0.03) of white–on-white perimetry. Some
of HRT parameters: CA, RA, CD, RV, CSM, HVC and RNFL in the group of all 80
eyes were significantly correlated to retinal nerve fiber layer loss. In the group
of glaucomatous eyes only, no significant correlations were found.
Conclusion: Combination of the structural and functional methods can
positively improve diagnosis of early glaucoma and better recognize the
progression of glaucomatous neuropathy of the optical nerve.
Key words:
glaucoma, perimetry, HRT, retinal nerve fiber layer, correlation
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