Potential of Stratus Optical Coherence Tomography for Detecting Early Glaucoma in Perimetrically Normal Eyes of Open-angle Glaucoma Patients With Unilateral Visual Field Loss

PURPOSE: To evaluate the potential of stratus optical coherence tomography (OCT) for detecting early glaucoma. PATIENTS AND METHODS: Fifty-two open-angle glaucoma patients with unilateral visual field loss detected by standard automatic perimetry were tested using stratus OCT and frequency doubling technology (FDT) N-30. Fifty-two perimetrically normal eyes were enrolled and divided into 2 groups: eyes with normal OCT results and eyes with abnormal OCT results. FDT parameters and scores were compared between the 2 groups. We evaluated the topographic relationship of the OCT-measured retinal nerve fiber layer (RNFL) defects with the FDT-measured visual field loss and glaucomatous optic neuropathy. RESULTS: In eyes with abnormal OCT results, the percentage of eyes with abnormal FDT results was significantly higher (P<0.001); FDT mean deviation, pattern standard deviation, and scores were significantly worse than those with normal OCT results (P=0.005, P<0.001, P<0.001, respectively); and the OCT-measured RNFL defects showed good topographic agreement with the FDT-measured visual field loss and glaucomatous optic neuropathy. CONCLUSIONS: RNFL defects detected by stratus OCT were associated with FDT visual field loss. Stratus OCT can detect early glaucoma sooner than standard automatic perimetry.