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목적 : To investigate the presence and pattern of cRNFL defects in glaucomatous eyes with varying degree of macular damage using spectral-domain OCT (SD-OCT) and evaluate the association of macular thickness change with that of cRNFL.
방법 : Glaucoma patients with macular structural damage defined by RTVue-100 SD-OCT ganglion cell complex analysis (GCC, P<0.01) were enrolled consecutively and divided into 3 groups [superior (SMG), inferior (IMG), and both macular damage groups (BMG)] according to disease severity using GCC analysis. The presence and location of cRNFL defects were evaluated and degree of topographic agreement between 2 structures was calculated. The pattern of cRNFL defects was classified into "diffuse" or "localized". Associations between macular damages, cRNFL damages and central 10-2 VF were evaluated.
결과 : A total of 145 eyes of 92 glaucoma patients were classified into 14 SMG, 53 IMG, and 78 BMG eyes. SMG, IMG, and BMG showed topographically-matching cRNFL defects in 85.7%, 88.7% and 70.5%, respectively (k=0.573, p<0.001). Of SMG, IMG, and BMG, 44.4%, 52.3% and 82.8% showed "diffuse" cRNFL defects. Both macular and cRNFL thickness showed significant correlations with each other and showed significant functional associations with central 10-2 VF sensitivity.
결론 : In glaucomatous eyes, macular damage is often accompanied by "diffuse" cRNFL defects and its prevalence increases with disease severity. There are significant thickness correlations between 2 parameters and good structure-function relationship between 2 parameters and central 10 degree VF sensitivity. Therefore, if macular damage is detected in glaucoma patients, one has to keep in mind presence of “diffuse” cRNFL” damage and central VF loss.
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