Discordance of Disc-Fovea Raphe Angles Determined by Optical Coherence Tomography and MP-3 Microperimetry in Eyes With a Glaucomatous Hemifield Defect

Invest Ophthalmol Vis Sci. 2019 Apr 1;60(5):1403-1411. doi: 10.1167/iovs.18-26354.

Abstract

Purpose: The purpose of this study was to evaluate the concordance of a temporal raphe architecture estimated using optical coherence tomography (OCT) and MP-3 microperimetry.

Methods: We enrolled 25 eyes with either an upper or lower glaucomatous hemifield defect, as detected on the Humphrey visual field 30-2 test. A structural temporal raphe was extrapolated from visible end points of retinal nerve fiber bundles present in a perimetrically normal hemiretina on an en face Spectralis OCT image. A functional temporal raphe was drawn as a line from the fovea to the border of at least a 10-dB difference in sensitivity, at vertically adjacent test points, with at least three consecutive pairs among 25 test points placed at 8° to 18° from the fovea (2° intervals) on the MP-3. An angle determined by the optic disc center, the fovea, and the temporal raphe line (the DFR angle) was calculated. Correlations and agreement of the OCT- and MP-3-derived DFR angles and factors affecting discordance of the two estimates were evaluated.

Results: Despite no significant demographic differences, the functional DFR angle (mean ± SD, 171.8° ± 3.5°) was significantly larger than that of the structural DFR angle (166.5° ± 3.2°) in 14 eyes with upper hemifield defects and vice versa in 11 eyes with lower hemifield defects (163.4° ± 3.0° vs. 170.5° ± 3.2°). The mean deviation was significantly associated with the functional and structural DFR angle difference in eyes with only upper hemifield defects.

Conclusions: The structural temporal raphe was more deviated to the perimetrically normal hemiretina side than to the functional temporal raphe, thereby suggesting that a structural change may precede a functional loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Fovea Centralis / physiopathology*
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers / pathology
  • Optic Disk / physiopathology*
  • Prospective Studies
  • Retinal Ganglion Cells / pathology
  • Tomography, Optical Coherence / methods*
  • Visual Field Tests / methods*
  • Visual Fields / physiology*