ANALYSIS OF CLINICAL RELATIONSHIP OF VISUAL ACUITY WITH OPTICAL COHERENCE TOMOGRAPHY AND PERIMETRY PARAMETERS IN PRIMARY OPEN-ANGLE GLAUCOMA

Abstract

Aims: This study aims to analyze the clinical relationship of visual acuity with optical coherence tomography and perimetry in primary open-angle glaucoma. Methods: This retrospective cross-sectional study was conducted with patients who were diagnosed with primary open-angle glaucoma in the ophthalmology department of Trakya University School of Medicine between January 2010 and January 2021. Perimetric data of patients such as visual field index, mean defect, pattern standard deviation, short-term fluctuation, corrected pattern standard deviation; results of optical coherence tomography such as average retinal nerve fiber layer thickness, average C/D ratio, and thickness of retinal nerve fiber layer quadrants, and records of examinational findings were statistically tested to evaluate the statistical relationship. Numbers, percentages, mean and standard deviation were used as the descriptive statistics. Results: Initially 80 eyes of 49 patients diagnosed with primary open-angle glaucoma met the inclusion criteria. 22 patients were female and 27 patients were male. Thinner mean retinal nerve fiber layer, inferior and superior quadrants were observed in eyes with lower visual acuity. It was observed that eyes with lower visual acuity had a worse visual field index and mean defect. Conclusion: In tertiary clinics that receive various numbers of patient referrals, perimetry can be seen as more useful and accurate in primary open-angle glaucoma detection and monitoring. It provides us with better and more accurate results for glaucoma management in the later stages. It is recommended that both optical coherence tomography and perimetry be used for disease monitoring, as this allows doctors to better monitor disease progression. In addition, since optical coherence tomography is an objective test and is less likely to require a patient response, it should be kept in mind that advanced and severe glaucoma may occur when performing perimetry, especially in patients with poor cooperation.

Keywords

• Glaucoma
• perimetry
• optical coherence tomography
• visual field
• epidemiology

References

1. 1.Kwon YH, Fingert JH, Kuehn MH et al. Primary open-angle glaucoma. N Engl J Med 2009;360(11):1113-24.
2. 2. Singh LN, Crowston JG, Lopez Sanchez MIG et al. Mitochondrial DNA variation and disease susceptibility in primary open-angle glaucoma. Invest Ophthalmol Vis Sci 2018;59(11):4598-602.
3. 3. Şimşek T. Current diagnosis and management of primary angle closure glaucoma. Osmangazi Journal of Medicine 2018;40(2):90-100.
4. 4. Kapetanakis VV, Chan MP, Foster PJ et al. Global variations and time trends in the prevalence of primary open angle glaucoma (POAG): a systematic review and meta-analysis. Br J Ophthalmol 2016;100(1):86-93.
5. 5. Kroese M, Burton H. Primary open angle glaucoma. The need for a consensus case definition. J Epidemiol Community Health 2003;57(9):752-4.
6. 6. Distelhorst JS, Hughes GM. Open-angle glaucoma. Am Fam Physician 2003;67(9):1937-44.
7. 7. Mahabadi N, Foris LA, Tripathy K. Open angle glaucoma. (cited 2020 Nov 20) Treasure Island (FL): StatPearls Publishing; 2021.
8. 8. Leske MC, Connell AM, Schachat AP et al. The Barbados Eye Study. Prevalence of open angle glaucoma. Arch Ophthalmol 1994;112(6):821-9.

9. 9. Wormald RP, Basauri E, Wright LA et al. The African Caribbean Eye Survey: risk factors for glaucoma in a sample of African Caribbean people living in London. Eye (Lond) 1994;8:315-20.
10. 10. Jiang X, Varma R, Wu S et al. Baseline risk factors that predict the development of open-angle glaucoma in a population: the Los Angeles Latino Eye Study. Oph- thalmology 2012;119(11):2245-53.
11. 11. Zhao D, Cho J, Kim MH et al. Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. Ophthalmology 2015;122(1):72-8.
12. 12. Zhou M, Wang W, Huang W et al. Diabetes mellitus as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. PLoS One 2014;9(8):102972.
13. 13. Omodaka K, Nakazawa T, Yokoyama Y et al. Correlation between peripapillary macular fiber layer thickness and visual acuity in patients with open-angle glau- coma. Clin Ophthalmol 2010;4:629-35.
14. 14. Leung CK, Chan WM, Yung WH et al. Comparison of macular and peripapillary measurements for the detection of glaucoma: an optical coherence tomography study. Ophthalmology 2005;112(3):391-400.
15. 15. Hood DC, Kardon RH. A framework for comparing structural and functional measures of glaucomatous damage. Prog Retin Eye Res 2007;26(6):688-710.
16. 16. Banegas SA, Anton A, Morilla A et al. Evaluation of the retinal nerve fiber layer thickness, the mean deviation, and the visual field index in progressive glaucoma. J Glaucoma 2016;25(3):229-35.
17. 17. Sommer A, Katz J, Quigley HA et al. Clinically detectable nerve fiber atrophy pre- cedes the onset of glaucomatous field loss. Arch Ophthalmol 1991;109(1):77-83.
18. 18. Abe RY, Diniz-Filho A, Zangwill LM et al. The relative odds of progressing by structural and functional tests in glaucoma. Invest Ophthalmol Vis Sci 2016;57(9):421-8.
19. 19. Ohnell H, Heijl A, Brenner L et al. Structural and functional progression in the early manifest glaucoma trial. Ophthalmology 2016;123(6):1173-80.
20. 20. Zhang X, Dastiridou A, Francis BA et al. Advanced imaging for glaucoma study group. Comparison of glaucoma progression detection by optical coherence to- mography and visual field. Am J Ophthalmol 2017;184:63-74.