Does the Enlargement of Retinal Nerve Fiber Layer Defects Relate to Disc Hemorrhage or Progressive Visual Field Loss in Normal-tension Glaucoma
Journal of Glaucoma, 03/16/2011
Nitta K et al. - The enlargement of retinal nerve fiber layer defects (RNFLD) in normal-tension glaucoma (NTG) was closely associated with Disc hemorrhage (DH) occurrence and the deterioration of visual field.
Authors reviewed NTG patients that were diagnosed and followed up for at least 3 years at 1-month to 2-month intervals by the same examiner, and selected eyes with distinct RNFLD borders.
Using fundus photographs, for which authors extracted only a blue ingredient and processed it into black and white, they measured RNFLD angles.
NTG cases were divided into 2 groups, enlarged RNFLD and stable RNFLD, and clinical characteristics were compared between both groups.
93 eyes from 93 patients (mean follow-up, 8.2 y) were selected.
Enlargement of RNFLD was detected in 55 eyes.
DH was found in 35 of 55 eyes (63.6%) in the enlarged group and in 6 of 38 eyes (15.8%) in the stable group (P<0.0001).
21 eyes (38.2%) from the enlarged group exhibited recurrent DH.
In 48 eyes (87.3%) from the enlarged group, the enlargement of RNFLD was toward the fovea.
When DHs located apart from RNFLD were excluded, RNFLD enlarged in the direction of DH in 21 of 25 eyes (84.0%).
The cumulative probability of non progression in the visual field was significantly lower in the enlarged group (10–year survival rate: 0.52±0.11) than in the stable group (10-year survival rate: 0.89±0.08) (P=0.0019).
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