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Structure-function relationship in glaucoma: Optical coherence tomography en face imaging vs. red-free fundus photography

Eye (2023)Cite this article

Subjects

Abstract

Background/Objectives

To analyse retinal nerve fibre layer (RNFL) defect measurements obtained from red-free fundus photography and optical coherence tomography (OCT) en face imaging, respectively, and to compare them for the strength of the structure–function association.

Subjects/Methods

Two hundred and fifty-six glaucomatous eyes of 256 patients with localized RNFL defect on red-free fundus photography were enrolled. A subgroup analysis included 81 highly myopic eyes (≤ –6.0 dioptres). Angular width of RNFL defect was compared between red-free fundus photography (i.e., red-free RNFL defect) and OCT en face imaging (i.e., en face RNFL defect). The correlation between angular width of each RNFL defect and functional outcomes, reported as mean deviation (MD) and pattern standard deviation (PSD), were assessed and compared.

Results

The angular width of en face RNFL defect was measured smaller than that of red-free RNFL defect in 91.0% eyes (mean difference, 19.98°). The association of en face RNFL defect with MD and PSD was stronger (R2 = 0.311 and R2 = 0.372, respectively) than that of red-free RNFL defect with MD and PSD (R2 = 0.162 and R2 = 0.137, respectively) (P < 0.05 for all). Especially in highly myopic eyes, the association of en face RNFL defect with MD and PSD was much stronger (R2 = 0.503 and R2 = 0.555, respectively) than that of red-free RNFL defect with MD and PSD (R2 = 0.216 and R2 = 0.166, respectively) (P < 0.05 for all).

Conclusions

En face RNFL defect showed a higher correlation with severity of visual field loss than did red-free RNFL defect. The same dynamic was observed for highly myopic eyes.

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Fig. 1: Angular width of retinal nerve fibre layer (RNFL) defect on red-free fundus photography and optical coherence tomography (OCT) en face imaging.
Fig. 2: Scatter plots of the values of visual field (VF) parameters against angular width of retinal nerve fibre layer (RNFL) defect.
Fig. 3: Representative cases of retinal nerve fibre layer (RNFL) angle on red-free fundus photography and OCT en face imaging in glaucoma patients.

Data availability

The datasets generated and analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Funding

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2019R1F1A1058426).

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Authors and Affiliations

  1. Department of Ophthalmology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea

    Eunoo Bak

  2. Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea

    Eunoo Bak & Hyuk Jin Choi

  3. Department of Ophthalmology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea

    Hyuk Jin Choi

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Conceptualisation, methodology: HJC Data curation, formal analysis, methodology: EB Writing original draft: EB Visualisation: EB Writing-review & editing: EB, HJC.

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Correspondence to Hyuk Jin Choi.

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Bak, E., Choi, H.J. Structure-function relationship in glaucoma: Optical coherence tomography en face imaging vs. red-free fundus photography. Eye (2023). https://doi.org/10.1038/s41433-023-02452-9

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