Visual Field Cluster Map Corresponding to Retinal Nerve Fiber Layer Sectors in Glaucoma

Jeong Hee Hwang; Ki Bang Uhm

doi:10.3341/jkos.2011.52.5.557

Journal List > J Korean Ophthalmol Soc > v.52(5) > 1009035

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Hwang and Uhm: Visual Field Cluster Map Corresponding to Retinal Nerve Fiber Layer Sectors in Glaucoma

Original Article

J Korean Ophthalmol Soc 2011;52(5):557-565.

Published online: 3 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.5.557

Visual Field Cluster Map Corresponding to Retinal Nerve Fiber Layer Sectors in Glaucoma

Jeong Hee Hwang, MD, Ki Bang Uhm, MD, PhD

Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea

Address reprint requests to Ki Bang Uhm, MD, PhD Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea #17 Haengdang-dong, Seongdong-gu, Seoul 133-792, Korea Tel: 82-2-2290-8570, Fax: 82-2-2291-8517, E-mail: KBUhm@hanyang.ac.kr

Received 30 September 201022 October 2010 Accepted 21 February 2011

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 generate a map relating visual field (VF) test points to corresponding areas of the retinal nerve fiber layer (RNFL) measured with optical coherence tomography (OCT) in patients with localized RNFL defects.

Methods

Twenty-four patients with preperimetric glaucoma and 173 patients with perimetric glaucoma, all with localized RNFL defects, underwent standard automated perimetry (SAP) and OCT measurements. To define zones of related point, factor analysis of the mean thresholds for the SAP test points was performed, independently for each hemifield. A map relating the VF zones to the 12 OCT sectors was plotted based on the strongest correlations between both techniques.

Results

Factor analysis divided the VF points into five VF zones for each hemifield. Distribution of the VF zones for the superior and inferior hemifields was slightly asymmetric. Linear regression results showed that superior VF zones corresponding to the superior arcuate and nasal step regions were best correlated with 6- and 7-o’clock RNFL sectors (inferior and inferior temporal) of thickness (r = 0.51-0.59). RNFL thinning (defined by abnormal sector at p < 5%) and regional de-creases in SAP sensitivity (defined by abnormal pattern deviation at p < 5%) were topographically related.

Conclusions

A newly developed VF cluster map revealed significant topographical structure-function relationships, espe-cially in the arcuate and nasal step region of the VF.

Go to :

Keywords: Factor analysis, Glaucoma, Optical coherence tomography, Retinal nerve fiber layer, Visual field map

References

1. Sommer A, Miller NR, Pollack I, et al. The nerve fiber layer in the diagnosis of glaucoma. Arch Ophthalmol. 1977; 95:2149–56.

2. Quigley HA, Addicks EM, Green WR. Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy. Arch Ophthalmol. 1982; 100:135–46.

3. Mikelberg FS, Yidegiligne HM, Schulzer M. Optic nerve axon count and axon diameter in patients with ocular hypertension and normal visual fields. Ophthalmology. 1995; 102:342–8.

4. Yamagishi N, Anton A, Sample PA, et al. Mapping structural damage of the optic disk to visual field defect in glaucoma. Am J Ophthalmol. 1997; 123:667–76.

5. Anton A, Yamagishi N, Zangwill L, et al. Mapping structural to functional damage in glaucoma with standard automated perimetry and confocal scanning laser ophthalmoscopy. Am J Ophthalmol. 1998; 125:436–46.

6. Garway-Heath DF, Poinoosawmy D, Fitzke FW, Hitchings RA. Mapping the visual field to the optic disc in normal tension glaucoma eyes. Ophthalmology. 2000; 107:1809–15.

7. Gardiner SK, Johnson CA, Cioffi GA. Evaluation of the struc-ture-function relationship in glaucoma. Invest Ophthalmol Vis Sci. 2005; 46:3712–7.

8. Mai TA, Reus NJ, Lemij HG. Structure-function relationship is stronger with enhanced corneal compensation than with variable corneal compensation in scanning laser polarimetry. Invest Ophthalmol Vis Sci. 2007; 48:1651–8.

9. Zangwill LM, Williams J, Berry CC, et al. A comparison of optical coherence tomography and retinal nerve fiber layer photography for detection of nerve fiber layer damage in glaucoma. Ophthalmology. 2000; 107:1309–15.

10. El Beltagi TA, Bowd C, Boden C, et al. Retinal nerve fiber layer thickness measured with optical coherence tomography is related to visual function in glaucomatous eyes. Ophthalmology. 2003; 110:2185–91.

11. Kanamori A, Nakamura M, Escano MF, et al. Evaluation of the glaucomatous damage on retinal nerve fiber layer thickness measured by optical coherence tomography. Am J Ophthalmol. 2003; 135:513–20.

12. Leung CK, Yung WH, Ng AC, et al. Evaluation of scanning resolution on retinal nerve fiber layer measurement using optical coherence tomography in normal and glaucomatous eyes. J Glaucoma. 2004; 13:479–85.

13. Weber J, Dannheim F, Dannheim D. The topographical relationship between optic disc and visual field in glaucoma. Acta Ophthalmol (Copenh). 1990; 68:568–74.

14. Wirtschafter JD, Becker WL, Howe JB, Younge BR. Glaucoma visual field analysis by computed profile of nerve fiber function in optic disc sectors. Ophthalmology. 1982; 89:255–67.

15. Kanamori A, Naka M, Nagai-Kusuhara A, et al. Regional relationship between retinal nerve fiber layer thickness and corresponding visual field sensitivity in glaucomatous eyes. Arch Ophthalmol. 2008; 126:1500–6.

16. Ferreras A, Pablo LE, Garway-Heath DF, et al. Mapping standard automated perimetry to the peripapillary retinal nerve fiber layer in glaucoma. Invest Ophthalmol Vis Sci. 2008; 49:3018–25.

17. Bowd C, Zangwill LM, Berry CC, et al. Detecting early glaucoma by assessment of retinal nerve fiber layer thickness and visual function. Invest Ophthalmol Vis Sci. 2001; 42:1993–2003.

18. Zangwill LM, Bowd C, Berry CC, et al. Discriminating between normal and glaucomatous eyes using the Heidelberg Retina Tomograph, GDx Nerve Fiber Analyzer, and Optical Coherence Tomograph. Arch Ophthalmol. 2001; 119:985–93.

19. Kamal DS, Garway-Heath DF, Hitchings RA, Fitzke FW. Use of sequential Heidelberg retina tomograph images to identify changes at the optic disc in ocular hypertensive patients at risk of developing glaucoma. Br J Ophthalmol. 2000; 84:993–8.

20. Parisi V, Manni G, Centofanti M, et al. Correlation between optical coherence tomography, pattern electroretinogram, and visual evoked potentials in open-angle glaucoma patients. Ophthalmology. 2001; 108:905–12.

21. Woo SW, Choi HW, Kim JS, Lee JH. Correlation between retinal nerve fiber layer thickness and visual field in normal tension glaucoma patients. J Korean Ophthalmol Soc. 2006; 47:1613–22.

22. Ahn YK, Uhm KB, Hong C. Correlation of the intrapapillary parameters to visual field defects in primary open-angle glaucoma. J Korean Ophthalmol Soc. 1997; 38:1027–36.

23. Airaksinen PJ, Mustonen E, Alanko HI. Optic disc haemorrhages precede retinal nerve fibre layer defects in ocular hypertension. Acta Ophthalmol (Copenh). 1981; 59:627–41.

24. Ogden TE, Duggan J, Danley K, et al. Morphometry of nerve fiber bundle pores in the optic nerve head of the human. Exp Eye Res. 1988; 46:559–68.

25. Quigley HA, Addicks EM. Regional differences in the structure of the lamina cribrosa and their relation to glaucomatous optic nerve damage. Arch Ophthalmol. 1981; 99:137–43.

26. Horn FK, Mardin CY, Viestenz A, Jünemann AG. Association between localized visual field losses and thickness deviation of the nerve fiber layer in glaucoma. J Glaucoma. 2005; 14:419–25.

27. Jonas JB, Fernández MC, Stürmer J. Pattern of glaucomatous neu-roretinal rim loss. Ophthalmology. 1993; 100:63–8.

28. Kim JH, Baek CE, Ahn YK, et al. Pattern of glaucomatous optic disc damage in primary open-angle glaucoma. J Korean Ophthalmol Soc. 1997; 38:1037–43.

Go to :

Figure 1.

The angular locations of photographic localized retinal nerve fiber layer (RNFL) defects in the right eye.

undefined

Figure 2.

Each of the test points of the C 24-2 was numbered for the factor analysis.

undefined

Figure 3.

Factor analysis generated the visual field points into five visual field zones for each hemifield. The diagram is for the right eye.

undefined

Figure 4.

Scatterplots of 7 clock-hour (inferior temporal) peripapillary retinal nerve fiber layer (RNFL) thickness measured with optical coherence tomography against visual field zone 3 (superior paracentral) sensitivity (or differential light sensitivity, DLS), expressed in the decibel scale (dB) (A) and in the antilog (1/Lambert) scale (B) in all eyes. VF = visual field.

undefined

Figure 5.

Diagram represent the percentage of the depressed points of p < 5% in the pattern deviation plot (A) and the percentage of optical coherence tomography retinal nerve fiber layer thickness p < 5% for each clock hour (B). The diagram is for the right eye.

undefined

Figure 6.

A new topographic visual field map generated from data in this study. Test points of the visual field were divided by the factor analysis. Visual field zones to corresponding clock-hour sectors measured with optical coherence tomography are shown (A). The corresponding sectors of the optic nerve head for visual field test points according to the results of the Garway-Heath et al study (B). The diagram is for the right eye.

undefined

Table 1.

Demographic and clinical characteristics of study subjects

Characteristics
Age (mean ± SD, yr)	56.6 ± 12.4
Gender (M/F)	113:84
Laterality (right/left)	80:117
Spherical equivalent (mean ± SD, diopter)	-0.86 ± 2.52
IOP (mean ± SD, mmHg)	14.03 ± 2.39
Central corneal thickness (mean ± SD, µm)	536.4 ± 36.4
Type of glaucoma
Preperimetric	24
Perimetric	173
SAP mean deviation (mean ± SD, dB)	-6.85 ± 6.04
SAP pattern standard deviation (mean ± SD, dB)	6.19 ± 4.11
Stage of glaucoma^*
No defect	24
Early defect	88
Moderate defect	42
Severe defect	43
Vertical cup-to-disc ratio (mean ± SD)	0.79 ± 0.09

Data are expressed as mean ± standard deviation.

SAP = standard automated perimetry.

^* Hodapp-Parrish-Anderson classification.

Table 2.

Rotated component matrix for the superior visual field (VF) points

VF point	Component
VF point	1	2	3	4	5	6
1	0.855	0.375	0.105	0.115	-0.037	0.034
2	0.873	0.354	0.113	0.139	-0.006	0.028
3	0.896	0.192	0.157	0.165	0.036	-0.055
4	0.913	0.183	0.124	0.175	0.118	-0.095
5	0.684	0.538	0.182	0.107	0.059	0.254
6	0.614	0.596	0.233	0.136	0.036	0.357
7	0.682	0.498	0.326	0.085	0.059	0.273
8	0.793	0.372	0.329	0.032	0.038	0.189
9	0.783	0.261	0.300	0.053	0.111	0.189
10	0.868	0.110	0.159	0.165	0.242	-0.019
11	0.416	0.798	0.195	0.174	0.017	0.150
12	0.335	0.771	0.324	0.147	0.114	0.274
13	0.299	0.724	0.365	0.164	0.139	0.345
14	0.278	0.568	0.607	0.164	0.135	0.147
15	0.293	0.310	0.813	0.139	-0.006	-0.001
16	0.325	0.349	0.729	0.205	0.021	0.243
17	0.717	0.258	0.412	0.155	0.262	0.147
18	0.759	0.110	0.174	0.160	0.521	-0.047
19	0.286	0.802	0.165	0.197	-0.001	-0.246
20	0.284	0.865	0.225	0.189	0.009	-0.043
21	0.213	0.825	0.363	0.149	0.139	0.042
22	0.143	0.670	0.582	0.203	0.164	-0.106
23	0.138	0.486	0.638	0.386	0.115	-0.172
24	0.283	0.309	0.210	0.825	0.148	0.047
25	0.235	0.350	0.460	0.699	0.060	0.027
26	0.592	0.188	0.083	0.222	0.670	0.058

The factor (column) with the largest loading of any particular variable (row) is shown in bold.

Table 3.

Rotated component matrix for the inferior visual field (VF) points

VF Point	Component
VF Point	1	2	3	4	5	6
27	0.750	0.201	0.126	0.212	0.248	0.364
28	0.720	0.266	0.291	0.259	0.147	0.388
29	0.682	0.209	0.360	0.299	0.178	0.320
30	0.567	0.196	0.611	0.247	0.189	0.180
31	0.295	0.356	0.567	0.442	0.264	0.127
32	0.291	0.237	0.215	0.805	0.236	-0.018
33	0.152	0.224	0.191	0.872	0.151	0.103
34	0.140	0.296	0.266	0.464	0.653	-0.179
35	0.858	0.237	0.227	0.118	0.205	-0.010
36	0.855	0.278	0.324	0.117	0.051	-0.037
37	0.658	0.310	0.550	0.145	0.013	0.005
38	0.455	0.252	0.762	0.155	0.226	-0.082
39	0.309	0.402	0.734	0.220	0.186	0.031
40	0.381	0.400	0.722	0.211	0.043	0.088
41	0.358	0.724	0.258	0.247	0.121	0.139
42	0.147	0.431	0.154	0.279	0.696	0.242
43	0.806	0.414	0.249	0.137	0.102	-0.035
44	0.821	0.354	0.269	0.179	0.013	-0.150
45	0.673	0.472	0.368	0.193	-0.043	0.116
46	0.552	0.563	0.388	0.303	-0.024	0.158
47	0.404	0.718	0.389	0.255	0.035	0.080
48	0.191	0.754	0.218	0.211	0.351	0.120
49	0.647	0.594	0.224	0.103	0.136	-0.087
50	0.549	0.690	0.277	0.139	0.117	-0.029
51	0.383	0.773	0.324	0.186	0.180	0.001
52	0.269	0.777	0.172	0.166	0.353	-0.040

The factor (column) with the largest loading of any particular variable (row) is shown in bold.

Table 4.

Pearson correlation coefficients between the mean threshold for each zones of the visual field (VF) and the RNFL thickness at each of the 12 clock-hour sectors measured with optical coherence tomography (OCT)

VF zone	OCT O’clock hour sector
VF zone	9	10	11	12	1	2	3	4	5	6	7	8
Superior
1	0.223^†						0.099	0.135	0.311^†	0.442^†	0.428^†	0.376^†
2	0.153^*						0.097	0.150	0.312^†	0.514^†	0.564^†	0.387^†
3	0.195^†						0.102	0.151^*	0.328^†	0.511^†	0.593^†	0.460^†
4	0.178^*						0.097	0.115	0.287^†	0.400^†	0.485^†	0.446^†
5	0.190^†						0.046	0.050	0.158^*	0.155^*	0.152^*	0.164^*
Inferior
1	0.242^†	0.354^†	0.465^†	0.318^†	0.155^*	0.083	0.048
2	0.298^†	0.358^†	0.403^†	0.313^†	0.216^†	0.082	0.039
3	0.267^†	0.397^†	0.434^†	0.275^†	0.168^*	0.087	0.067
4	0.196^†	0.208^†	0.230^†	0.186^†	0.111	0.073	0.046
5	0.097	0.122	0.176^*	0.220^†	0.173^*	0.076	0.052

^* Correlation is significant at the 0.05 level (2-tailed);

^† Correlation is significant at the 0.01 level (2-tailed).

TOOLS

Similar articles