J Korean Ophthalmol Soc.  2019 May;60(5):455-462. 10.3341/jkos.2019.60.5.455.

Comparison of Retinal Ganglion Cell Damage in Glaucoma and Retinal Vein Occlusion by Visual Field

• Lee J
• Jeon S
• Park HY

• KMID: 2445139
• DOI: http://doi.org/10.3341/jkos.2019.60.5.455

Abstract

PURPOSE
We analyzed and compared retinal ganglion cell damage between patients with glaucoma and those with branched retinal vein occlusion (BRVO). We performed two types of visual field examinations.
METHODS
We retrospectively reviewed the medical records of 40 glaucoma eyes and 40 BRVO eyes. We compared the median deviation (MD), the pattern standard deviation (PSD), and sensitivity of damaged visual hemifield from frequency-doubling technology (FDT) C24-2 and standard automated perimetry (SAP) C24-2 visual field tests evaluation. We sought correlations between the MDs and retinal nerve fiber layer thickness as revealed by optical coherence tomography.
RESULTS
MDs did not differ between the groups. PSD value was higher in glaucoma patients with FDT C24-2 test (p = 0.022), but no difference between two groups with SAP C24-2 test (p = 0.144). In terms of the sensitivity of the damaged visual hemifield, glaucoma patients had larger areas of damage in the FDT C24-2 test (p < 0.01). In regression analyses, the log R2 values of both tests were higher in glaucoma patients.
CONCLUSIONS
Glaucoma patients had a greater damaged visual field area in the FDT C24-2 test than the SAP C24-2 test. The BRVO patients exhibited similar extents of damage in both tests. Thus, the subtypes and distributions of damaged retinal ganglion cells may differ between the conditions, facilitating differential diagnosis.

Keyword

Glaucoma; Retinal ganglion cell; Retinal vein occlusion; Visual field

MeSH Terms

Diagnosis, Differential
Glaucoma*
Humans
Medical Records
Nerve Fibers
Retinal Ganglion Cells*
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Retrospective Studies
Tomography, Optical Coherence
Visual Field Tests
Visual Fields*
Retinaldehyde

Figure

• 

  Figure 1 Percentage of abnormal points in the FDT C24-2 and SAP 24-2. It is based on confidential limits of 5% and 1% on glaucoma patients and BRVO patients. FDT = frequency doubling technique; SAP = standard automated perimetry; BRVO = branched retinal vein occlusion; Conf. limits = confidential limits.

• 

  Figure 2 Comparison as mean difference between FDT C24-2 and SAP C24-2 on glaucoma patients and BRVO patients. The percentage of the raw sensitivity points and where the confidence limit is less than 5% and 1% was calculated. FDT = frequency doubling technique; SAP = standard automated perimetry; BRVO = branched retinal vein occlusion. *The difference of raw sensitivity value from FDT C24-2 to SAP C24-2. In glaucoma patients, it was positive value but in BRVO patients, it was negative value.

• 

  Figure 3 Correlation between average RNFL thickness and median deviation categorized by diagnosis and visual field examination. (A) Glaucoma patients, FDT C24-2 (B) glaucoma patients, SAP C24-2 (C) BRVO patients, FDT C24-2 (D) BRVO patients, SAP C24-2. FDT = frequency doubling technique; SAP = standard automated perimetry; BRVO = branched retinal vein occlusion; RNFL = retinal nerve fiber layer.

• 

  Figure 4 A 41-year-old patient with NTG at superior hemifield and BRVO at inferior hemifield. (A) FDT C24-2 and SAP C24-2. On superior hemifield, the FDT C24-2 showed progressive visual defect than SAP C24-2, but on inferior hemifield two examination showed smiliar results. (B) OCT showed superior and inferior RNFL defect. (C) Disc and red-free photographs show glaucomatous cupping and localized RNFL defect. NTG = normal tension glaucoma; BRVO = branched retinal vein occlusion; FDT = frequency doubling technique; SAP = standard automated perimetry; RNFL = retinal nerve fiber layer; OCT = optical coherence tomography.

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