Correlation of Retinal Nerve Fibre Layer Thickness with Visual Field Changes in Primary Open-Angle Glaucoma: A Cross-Sectional Study
Keywords:
primary open-angle glaucoma; retinal nerve fibre layer; optical coherence tomography; visual field; structure–function; mean deviation..Abstract
Background: Primary open-angle glaucoma (POAG) causes progressive retinal ganglion cell loss expressed structurally as retinal nerve fibre layer (RNFL) thinning and functionally as visual field (VF) loss. Quantifying the structure–function relationship supports diagnosis and staging. Objectives: To correlate optical coherence tomography (OCT)–measured RNFL thickness with VF indices in POAG, and to examine RNFL thickness across VF severity strata. Methods: A cross-sectional study of 150 eyes of 150 patients with POAG assessed average and sectoral peripapillary RNFL thickness by OCT and VF mean deviation (MD), visual field index (VFI) and pattern standard deviation (PSD) by automated perimetry. Associations used Pearson and Spearman correlation; RNFL thickness across VF severity (mild/moderate/severe) was compared by one-way ANOVA. Results: Patients had a mean age of 60.4 ± 10.0 years; mean IOP was 16.8 ± 2.6 mmHg and mean cup-to-disc ratio 0.7 ± 0.1. Mean average RNFL was 72.2 ± 12.3 µm and mean VF MD −8.6 ± 6.4 dB. Average RNFL correlated strongly with VF MD (r = 0.94, p < 0.001) and VFI (r = 0.92, p < 0.001), and inversely with PSD (r = −0.86) and cup-to-disc ratio (r = −0.84); the Spearman coefficient for RNFL–MD was 0.91. RNFL thickness decreased stepwise across VF severity (mild 82.4, moderate 71.7, severe 54.7 µm; ANOVA p < 0.001). All four sectoral RNFL measurements correlated significantly with VF MD (r = 0.87–0.90). Conclusion: OCT-measured RNFL thickness was strongly and consistently correlated with visual field loss across the severity spectrum of POAG, supporting the complementary use of structural and functional testing in glaucoma assessment and staging..
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