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David S. Greenfield, MD; Harmohina Bagga, MD; Robert W. Knighton, PhD

Arch Ophthalmol. 2003;121:41-46.

Objective  To correlate macular thickness and retinal nerve fiber layer (RNFL) thickness in normal and glaucomatous eyes using optical coherence tomography.

Methods  Complete examination, automated achromatic perimetry, and optical coherence tomography of the peripapillary RNFL and macula were performed. Exclusion criteria were visual acuity of less than 20/40, diseases other than glaucoma, and unreliable automated achromatic perimetry. Macular thickness measurements were generated using 6 radial optical coherence tomographic scans (5.9 mm) centered on the fovea, and mean and quadrantic macular thickness values were calculated.

Results  Fifty-nine eyes of 59 patients (29 normal and 30 glaucomatous) were enrolled (mean ± SD age, 56.7 ± 20.3 years; range, 20-91 years). All eyes with glaucoma had associated visual field loss (mean ± SD mean defect, -8.4 ± 5.8 dB). Mean macular thickness was significantly associated with visual field mean defect (R² = 0.47; P<.001), pattern standard deviation (R² = 0.32; P<.001), and mean RNFL thickness (R² = 0.38; P<.001). In glaucomatous eyes with visual field loss localized to 1 hemifield (n = 11), mean ± SD macular thickness in the quadrant associated with the field defect (277 ± 28 µm) was significantly less (P = .005) than in the unaffected quadrant (286 ± 27 µm). Mean RNFL thickness in the affected quadrant (89 ± 53 µm) was significantly thinner (P = .009) than in the unaffected quadrant (121 ± 39 µm).

Main Outcome Measures  Mean total and quadrantic macular and RNFL thickness measurements.

Conclusions  Macular thickness changes are well correlated with changes in visual function and RNFL structure in glaucoma and may be a surrogate indicator of retinal ganglion cell loss.

From the Department of Ophthalmology, University of Miami School of Medicine, Bascom Palmer Eye Institute, Miami, Fla. The authors have no financial interest in any device or technique described in this article.

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