Retinal Nerve Fiber Layer Measurement by Optical Coherence Tomography in Glaucoma Suspects with Short-Wavelength Perimetry Abnormalities

PURPOSE: To compare retinal nerve fiber layer (RNFL) measurements in normal and glaucoma subjects with short-wavelength automatic perimetry (SWAP) abnormalities and in chronic primary open-angle glaucoma (CPOAG) patients using optical coherence tomography (OCT). METHODS: Forty-eight eyes of normal subjects, 34 eyes of glaucoma suspects with SWAP abnormalities, and 38 eyes of early CPOAG subjects were recruited. All normal and glaucoma suspects had normal conventional automated perimetry visual field results. All participants underwent full clinical ophthalmologic evaluation followed by OCT RNFL measurements. RESULTS: Compared with normal controls, OCT RNFL thickness was significantly lower in glaucoma suspects with abnormal SWAP (inferotemporal and superotemporal thickness values) and CPOAG patients (average, superior, inferior, inferotemporal, and superotemporal thickness values) (P < 0.01). Some parameters were found to be significantly lower in CPOAG patients than the glaucoma suspects with abnormal SWAP (average, inferior, inferotemporal, and superotemporal thickness values) (P < 0.01). CONCLUSIONS: OCT RNFL measurements appear to correlate well with SWAP abnormalities in glaucoma, and may detect glaucomatous damage earlier than standard conventional automated perimetry. This study suggests that OCT may recognize the earliest evidence of structure alterations in CPOAG.