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Decreasing macular thickness may correspond with visual hemifield defects
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Macular retinal thickness measurements diminished as visual hemifield defects increased, according to a study.
The study authors said that this implies measuring macular thickness by optical coherence tomography may help predict central visual function of glaucoma patients.
The retrospective study included 39 eyes of 39 patients with normal-tension or primary open-angle glaucoma and superior or inferior hemifield defects. The mean age of the patients was 66.5 years. Twenty-seven eyes had superior hemifield defects, and 12 eyes had inferior hemifield defects.
Study results showed that retinal thickness of the parafovea and fovea centralis diminished significantly as the hemifield defect increased.
"The retinal thickness of the parafovea, the inner sector, outer sector, and inner and outer sectors, corresponding to the apparently normal hemifields, significantly decreased with the progression of the hemifield defect on the other side," the study authors said.
Perspective
Back to TopJesse Richman, MD, and Marlene R. Moster, MD
Using OCT to measure the thickness of the inner retina in the macular region shows promise as a diagnostic tool for glaucoma. A retrospective study of 39 glaucoma patients with hemifield loss found a strong relationship (r = 0.726, P < .001) between 10-2 visual field loss and the thickness of its corresponding inner parafoveal layers. There was no relationship between macular thickness and the portion of the field without glaucomatous damage.
Considering that structural changes typically occur prior to field loss, it would be expected that a strong relationship would exist in patients with established hemifield loss. A prospective study aimed at finding the rate and incidence of field loss in patients with thinning of the inner retina and a normal initial field may be more helpful in guiding management decisions. Nevertheless, changes in the macular region, which can now be detected earlier by OCT, are an additional piece of information aiding in the care of glaucoma patients.
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