Comparison of Frequency Doubling Technology Perimeter and RNFL Photography for Early Diagnosis of Glaucoma

Jun Sung Lee; Hwan Heo; Sang Woo Park; Kun-Jin Yang

doi:10.3341/jkos.2009.50.11.1674

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Lee, Heo, Park, and Yang: Comparison of Frequency Doubling Technology Perimeter and RNFL Photography for Early Diagnosis of Glaucoma

Original Article

J Korean Ophthalmol Soc 2009;50(11):1674-1679.

Published online: 31 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.11.1674

Comparison of Frequency Doubling Technology Perimeter and RNFL Photography for Early Diagnosis of Glaucoma

Jun Sung Lee, MD¹, Hwan Heo, MD¹, Sang Woo Park, MD¹, Kun-Jin Yang, MD²

¹Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea

²Best Eye Clinic, Gwangju, Korea

Address reprint requests to Sang Woo Park, MD, Department of Ophthalmology, Chonnam National University Medical School and Hospital #8 Hak-dong, Dong-gu, Gwangju 501-757, Korea Tel: 82-62-220-6743, Fax: 82-62-227-1642, E-mail: exo70@jnu.ac.kr

Received 3 November 2009 Accepted 7 April 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the frequency doubling technology perimeter (FDT) with retinal nerve fiber layer (RNFL) photography as a tool for the early detection of glaucoma.

Methods

Ninety-eight eyes of 98 patients were evaluated over a period of 3 months. According to the results of RNFL photography and FDT, Patients were divided into four groups based on the results of RNFL photography and optical coherence tomography (OCT). A comparison of the RNFL thickness of each group was performed using the OCT results.

Results

RNFL thickness in the group with abnormal FDT and normal RNFL were significantly decreased from those in the group with normal FDT and RNFL photography at the 6, 7 and, 10 o’ clock area (p<0.05).

Conclusions

There were statistically significant differences in the RNFL thickness between the group with abnormal FDT and normal RNFL photography, and the group with normal FDT and RNFL photography within the limited areas. These results imply that FDT is more useful for the early detection of glaucoma than RNFL photography.

Keywords: FDT, Glaucoma, RNFL photography, Stratus OCT

References

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Table 1.

Patient demographics and clinical characteristics of each group

	Group 1	Group 2	Group 3	p
Number	33	23	36
Gender (Male/Female)	21/12	14/9	14/22	0.183^‡
Age	57.6±10.4	60.1±9.2	66.1±8.3	0.001^§
Spherical equivalent (D)	−0.76±1.09	−0.42±1.43	0.81±1.61	0.782^§
BCVA^П (LogMar)	0.07±0.02	0.09±0.04	0.11±0.04	0.119^§
Intraocular pressure (mmHg)	12.67±1.45	13.43±1.34	13.75±2.67	0.079^§
Central corneal thickness (μm)	548.97±22.11	544.96±22.82	551.00±24.75	0.625^§
SAP^# MD^* (dB)	−1.03±1.58	−2.13±1.39	−6.68±2.74	0.001^§
SAP^# PSD^† (dB)	1.76±0.92	2.99±1.67	7.10±2.65	0.001^§
FDT^** MD^* (dB)	−2.43±1.75	−3.42±1.27	−7.04±4.06	0.001^§
FDT^** PSD^† (dB)	1.94±1.27	3.74±0.99	6.65±2.98	0.001^§

^*MD=mean deviation

^†PSD=pattern standard deviation

^‡Chi-square test

^§Analysis of variance (ANOVA)

^ПBCVA=best corrected visual acuity

^#SAP=standard automated perimetry

^**FDT=frequency doubling technology.

Table 2.

Mean retinal nerve fiber layer thickness measured by optical coherence tomography

	Group 1	Group 2	Group 3	p	Post Hoc
Average (μm)	93.5±12.0	89.1±14.2	72.4±22.7	<0.001	1, 2 vs 3
Nasal quadrant (μm)	74.9±25.6	69.3±18.1	54.6±16.0	<0.001	1, 2 vs 3
Inferior quadrant (μm)	125.0±13.2	102.1±25.1	92.2±38.2	<0.001	1, 2 vs 3
Temporal quadrant (μm)	65.8±26.0	69.0±17.1	57.6±18.0	0.094
Superior quadrant (μm)	116.3±19.2	92.1±20.1	85.4±27.7	<0.001	1, 2 vs 3
1-o'clock (μm)	101.8±26.8	103.0±26.7	81.3±27.5	0.002	1, 2 vs 3
2-o'clock (μm)	74.0±27.8	79.9±20.1	64.6±22.0	0.045	2 vs 3
3-o'clock (μm)	64.2±18.0	59.2±17.1	47.0±14.2	0.002	1, 2 vs 3
4-o'clock (μm)	60.6±15.1	55.0±7.1	53.9±16.6	0.125
5-o'clock (μm)	107.9±32.7	93.3±36.7	86.4±43.0	0.039	1 vs 3
6-o'clock (μm)	129.3±38.0	101.9±42.7	97.2±43.0	0.001	1 vs 2, 3
7-o'clock (μm)	125.2±33.7	99.8±29.0	87.8±41.4	<0.001	1 vs 2, 3
8-o'clock (μm)	80.5±31.7	65.7±18.1	59.8±20.3	0.002	1 vs 3
9-o'clock (μm)	63.5±20.1	56.4±14.0	48.1±12.0	0.001	1 vs 3
10-o'clock (μm)	94.5±37.6	73.6±22.3	63.1±25.9	<0.001	1 vs 2, 3
11-o'clock (μm)	124.5±33.1	107.4±27.1	90.7±32.8	<0.001	1 vs 3
12-o'clock (μm)	122.0±31.8	110.1±26.7	84.6±30.7	<0.001	1, 2 vs 3

Table 3.

Proportion of eyes with RNFL thickness confidence interval <5% in group 1 and group 2

	Group 1	Group 2	p
Average	3 (9%)	5 (22%)	0.183
Nasal quadrant	5 (15%)	7 (30%)	0.170
Inferior quadrant	3 (9%)	7 (30%)	0.040
Temporal quadrant	3 (9%)	4 (17%)	0.355
Superior quadrant	5 (15%)	8 (35%)	0.087
1-o'clock	4 (12%)	7 (30%)	0.090
2-o'clock	4 (12%)	5 (22%)	0.335
3-o'clock	3 (9%)	5 (22%)	0.183
4-o'clock	4 (12%)	6 (26%)	0.179
5-o'clock	3 (9%)	5 (22%)	0.183
6-o'clock	3 (9%)	7 (30%)	0.040
7-o'clock	4 (12%)	7 (30%)	0.090
8-o'clock	4 (12%)	7 (30%)	0.090
9-o'clock	5 (15%)	8 (35%)	0.087
10-o'clock	5 (15%)	7 (30%)	0.170
11-o'clock	2 (6%)	4 (17%)	0.177
12-o'clock	4 (12%)	6 (26%)	0.179

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