Retinal Nerve Fiber Loss Pattern in High-Tension Glaucoma by Optical Coherence Tomography

PURPOSE: To identify the pattern of retinal nerve fiber layer thinning in high-tension primary chronic open-angle glaucoma (HT-PCOAG) using optical coherence tomography. METHODS: Retinal nerve fiber layer thickness was assessed with optical coherence tomography in 68 healthy controls and 68 age- and refractive error-matched patients with HT-PCOAG were recruited. Patients were divided into 3 subgroups according to their visual field mean deviation: early (> -3 dB), moderate (-3 to -7 dB), and moderately advanced (-7 to -15 dB). RESULTS: Retinal nerve fiber layer thickness values in inferotemporal and superotemporal regions were significantly lower in all groups of glaucomatous eyes than in healthy eyes (P<0.001). Inferotemporal thickness values were significantly lower than the superotemporal thickness values (P<0.001) in the early glaucomatous stage, but not significantly so in moderate and moderately advanced stages. CONCLUSIONS: Besides a diffuse retinal nerve fiber layer defect, a localized defect may present in the inferotemporal region in early-stage HT-PCOAG. These results also suggest that optical coherence tomography shows promise in providing quantitative data about the location and extent of retinal nerve fiber layer injury in glaucoma, and the findings are consistent with previous knowledge.