Circumpapillary structure-function relationships with microperimetry and spectral domain optical coherence tomography in glaucoma: a pilot study

Figures & data

Table 1 Demographics of participants

	Healthy controls (n=14)	Glaucoma group (n=22)	P-value
Age (years, mean ± SD)	44.0±12.9	65.6±7.0	<0.001**
IOP (mmHg, mean ± SD)	14.6±2.3	17.3±3.2	0.009**
Spherical equivalent (D, mean ± SD)	−1.95±2.01	−1.70±2.58	0.756
MD (dB, mean ± SD)	0.41±1.13	−4.60±3.47	<0.001**
PSD (dB, mean ± SD)	1.49±0.25	8.17±3.77	<0.001**
Glaucoma severity	NA	Early 14/moderate 8

Notes:

** P<0.01 (Student’s t-test). Early glaucoma ¹¹ = MD > −6 dB; moderate glaucoma ¹¹ = −6 dB ≥ MD > −12 dB.

Abbreviations: MD, mean deviation; NA, not applicable; PSD, pattern standard deviation.

Figure 1 A typical example of a circumpapillary spectral-domain optical coherence tomography scan.

Notes: (A) Retinal layer boundaries were automatically detected by the image-segmentation algorithm. cpRNFL, cpGCC, cpOR, and cpTR thickness were measured. (B) Circumpapillary retinal layer sectors used for the analysis in the current investigation are shown. Retinal thickness measurements were performed around a 3.45 mm diameter circle.
Abbreviations: cpGCC, circumpapillary ganglion cell complex; cpOR, circumpapillary outer retina; cpRNFL, circumpapillary retinal nerve fiber; cpTR, circumpapillary total retina; I, inferior; N, nasal; S, superior; T, temporal.

Figure 2 A typical example of a normal eye.

Notes: Color fundus photograph (A). Humphrey 30-2 Swedish interactive threshold-algorithm visual field: (B) gray scale; (C) threshold-sensitivity values. The 12 cpRNFL (D), cpGCC (E), cpOR (F), and cpTR (G) sectors. The 12 circumpapillary microperimetry-sensitivity sectors (H) of the normal right eye of a 46-year-old male subject.
Abbreviations: cpGCC, circumpapillary ganglion cell complex; cpOR, circumpapillary outer retina; cpRNFL, circumpapillary retinal nerve fiber; cpTR, circumpapillary total retina.

Figure 3 A typical example of a glaucoma eye.

Notes: Color fundus photograph (A). Humphrey 30-2 Swedish interactive threshold-algorithm visual field: (B) gray scale; (C) threshold-sensitivity values. The 12 cpRNFL (D), cpGCC (E), cpOR (F), and cpTR (G) sectors. The 12 circumpapillary microperimetry-sensitivity sectors (H) of the glaucomatous left eye of a 60-year-old female primary open-angle glaucoma patient. Inferotemporal structural damage (neuroretinal rim loss on A and RNFL thinning on D) corresponded spatially with the superior Bjerrum scotoma shown by the Humphrey visual field (B, C). The circumpapillary microperimetry test (H) showed significant inferotemporal sensitivity reduction around the disk.
Abbreviations: cpGCC, circumpapillary ganglion cell complex; cpOR, circumpapillary outer retina; cpRNFL, circumpapillary retinal nerve fiber; cpTR, circumpapillary total retina.

Table 2 Comparison of various circumpapillary retinal thickness sectors between groups

OCT sector	Healthy controls	Glaucoma group	P-value	Healthy controls	Glaucoma group	P-value
	Mean ± SD (μm)	Mean ± SD (μm)		Mean ± SD (μm)	Mean ± SD (μm)
	cpRNFL			cpGCC
1	146.7±17.5	92.6±32.7	<0.001	191.2±18.2	136.4±34.5	<0.001
2	84.9±7.4	69.9±19.7	0.003	142.0±10.7	118.5±24.7	<0.001
3	61.8±8.4	59.2±11.5	0.470	122.2±8.6	114.0±16.3	0.058
4	76.2±14.8	53.0±10.2	<0.001	133.6±14.8	104.9±17.0	<0.001
5	144.6±25.4	64.3±24.3	<0.001	189.4±21.2	102.2±28.3	<0.001
6	130.1±20.9	82.4±23.2	<0.001	176.8±23.4	122.6±27.8	<0.001
7	91.4±17.9	72.3±20.9	0.008	139.4±17.6	115.5±19.0	0.001
8	61.0±13.9	51.4±9.7	0.020	111.5±15.9	98.1±14.4	0.013
9	51.6±13.3	49.0±8.3	0.465	102.1±16.5	93.8±11.9	0.088
10	80.1±15.2	63.6±16.6	0.005	129.2±18.6	109.0±19.8	0.004
11	106.6±18.2	81.6±23.1	0.002	154.2±18.9	126.4±24.6	0.001
12	125.9±24.4	88.1±24.1	<0.001	172.0±28.1	130.3±28.5	<0.001
	cpTR			cpOR
1	351.1±26.5	303.8±38.8	<0.001	159.9±18.0	167.5±13.4	0.160
2	318.2±16.1	297.1±25.0	0.008	176.2±13.4	178.6±12.5	0.592
3	300.6±20.4	294.1±23.4	0.405	178.4±15.3	180.1±16.8	0.757
4	311.2±21.4	283.0±25.1	0.001	177.6±13.7	178.0±16.2	0.939
5	345.9±24.9	270.3±28.2	<0.001	156.5±15.8	168.1±13.4	0.024
6	335.6±25.4	284.0±31.5	<0.001	158.8±6.8	161.4±11.1	0.434
7	305.5±19.4	277.2±24.7	0.001	166.1±11.2	161.7±12.2	0.284
8	285.5±17.8	266.9±19.0	0.006	174.0±12.4	168.7±10.0	0.170
9	281.1±23.3	266.5±18.9	0.047	179.1±11.2	172.8±10.8	0.104
10	302.8±20.8	277.4±23.1	0.002	173.6±9.6	168.5±11.0	0.163
11	323.9±19.3	288.6±28.4	<0.001	169.7±12.1	162.3±11.2	0.068
12	339.1±22.0	295.9±32.7	<0.001	167.1±16.4	165.5±12.9	0.747

Note: The values presented in bold are statistically significant (Student’s t test).

Abbreviations: cpGCC, circumpapillary ganglion-cell complex; cpOR, circumpapillary outer retina; cpRNFL, circumpapillary retinal nerve fiber; cpTR, circumpapillary total retina; OCT, optical coherence tomography.

Table 3 Comparison of circumpapillary retinal sensitivity between groups

Sector	Healthy controls	Glaucoma group	P-value
	Median (IQR), dB	Median (IQR), dB
1	26.5 (3.25)	24.0 (4.75)	0.003
2	27.0 (4.00)	25.0 (3.25)	0.027
3	29.0 (3.00)	26.5 (4.25)	0.004
4	27.0 (3.13)	25.0 (4.00)	0.004
5	26.5 (4.50)	17.5 (19.25)	<0.001
6	27.0 (6.00)	21.0 (12.50)	<0.001
7	27.5 (4.00)	25.0 (3.50)	0.003
8	27.0 (2.25)	25.5 (2.25)	0.019
9	27.5 (2.88)	26.0 (3.00)	0.009
10	27.0 (4.25)	25.5 (3.25)	0.032
11	27.0 (2.38)	24.5 (3.75)	0.009
12	26.5 (4.25)	25.0 (4.25)	0.057

Note: The values presented in bold are statistically significant (Mann-Whitney U test).

Table 4 Correlation between circumpapillary retinal thickness parameters and the corresponding retinal sensitivity thresholds in total population (n=36)

MP-3 sector	OCT sector	cpRNFL, r	P-value	cpTR, r	P-value	cpGCC, r	P-value	cpOR, r	P-value
1	1	0.448	0.006	0.514	0.001	0.508	0.002	0.134	0.437
2	2	0.274	0.106	0.469	0.004	0.465	0.004	0.132	0.444
3	3	−0.159	0.355	0.348	0.037	0.349	0.037	0.170	0.322
4	4	0.251	0.140	0.360	0.031	0.389	0.019	0.063	0.716
5	5	0.711	<0.001	0.731	<0.001	0.756	<0.001	−0.250	0.141
6	6	0.437	0.008	0.509	0.002	0.496	0.002	0.190	0.266
7	7	0.097	0.573	0.318	0.059	0.286	0.091	0.123	0.473
8	8	0.325	0.053	0.189	0.269	0.238	0.163	0.031	0.860
9	9	0.156	0.365	0.180	0.295	0.197	0.249	0.092	0.595
10	10	0.455	0.005	0.554	<0.001	0.439	0.007	0.336	0.045
11	11	0.360	0.031	0.520	0.001	0.382	0.021	0.372	0.025
12	12	0.276	0.103	0.542	0.001	0.343	0.041	0.494	0.002

Notes: r represents Spearman’s rank correlation coefficient. The values presented in bold are statistically significant.

Abbreviations: cpGCC, circumpapillary ganglion-cell complex; cpOR, circumpapillary outer retina; cpRNFL, circumpapillary retinal nerve fiber; cpTR, circumpapillary total retina.

Figure 4 Scatterplots of associations between visual field mean deviation and superotemporal and inferotemporal circumpapillary retinal sensitivity.

Notes: (A) Relationship between circumpapillary retinal sensitivity determined for sector 1 (superotemporal sector) and mean deviation. (B) Relationship between circumpapillary retinal sensitivity determined for sector 5 (inferotemporal sector) and mean deviation. Significant correlations were found for both sectors (sector 1, r=0.470; P=0.04; sector 5; r=0.685, P<0.001).

HodappEParrishRKAndersonDRClinical decisions in glaucomaSt LouisMosby19935261

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