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Clinical Sciences
September 1998

Foveal Dysfunction and Central Visual Field Loss in Glaucoma

Author Affiliations

From the Division of Ophthalmology, St Luke's Medical Center, Cleveland, Ohio (Drs Weiner, Ripkin, Patel, Kaufman, Kohn, and Weidenthal), and Northeast Ohio Eye Surgeons, Kent (Dr Ripkin). The authors have no proprietary interest in any equipment used in this study.

Arch Ophthalmol. 1998;116(9):1169-1174. doi:10.1001/archopht.116.9.1169

Objective  To determine whether foveal function distal to the ganglion cell layer is an independent predictor of central visual field function in glaucoma.

Setting  University affiliated hospital and private practice.

Participants  Twenty-seven eyes (27 patients) with normal-pressure glaucoma, 10 eyes (10 patients) with primary open-angle glaucoma, and 47 eyes of 47 matched normal volunteers.

Intervention and Main Outcome Measures  Foveal cone electroretinogram (ERG) amplitude, relative optic cup to disc area and their relations to Humphrey full-threshold 30-2 visual field central 4-point mean total deviation (C4MTD) and pattern deviation (C4MPD).

Results  Foveal cone ERG amplitude was subnormal in 14 (37.8%) of the 37 glaucomatous eyes and lower in the glaucoma group compared with normal eyes (P<.01). The C4MTD and C4MPD were lower in glaucomatous eyes with subnormal amplitudes compared with those with normal amplitudes (P<.01 and P <.05, respectively). Amplitude was directly correlated with C4MTD (P<.01) and C4MPD (P<.01). Relative optic cup to disc area was inversely correlated with C4MTD (P<.001) and C4MPD (P<.001). Partial correlation analysis revealed that amplitude and relative optic cup to disc area were independent predictors of C4MTD and C4MPD.

Conclusion  Foveal function distal to the ganglion cell layer and optic disc cupping independently predict central visual field function in glaucoma.