Correlation Between Macular, Retinal Nerve Fiber Layer Thickness, and Visual Field in Open Angle Glaucoma

PURPOSE: This study was performed to evaluate the macular and peripapillary retinal nerve fiber layer (RNFL) thickness and to evaluate their association with glaucomatous visual field change. METHODS: Forty normal eyes of 24 subjects, 30 ocular hypertension eyes of 15 patients, 30 pre-perimetric glaucoma eyes of 18 patients and 90 open angle glaucoma eyes of 59 patients. The macularand peripapillary RNFL thickness were measured by the optical coherence tomography (Stratus OCT(TM) model 3000, Carl Zeiss Meditec) and visual field tests were performed by the Humphrey's automated perimetry. RESULTS: There was a significant decrease of both the macular (p<0.05) and peripapillary RNFL thickness (p<0.001) in the open angle glaucoma group compared with the normal group. In 190 eyes, statistically significant positive relationship was demonstrated between mean deviation (MD) and all areas of peripapillary RNFL thickness (p<0.001) as well as between MD and all areas of macular thickness except the fovea, central ring (p<0.01). CONCLUSIONS: The macular and peripapillary RNFL thickness were significantly decreased and the findings indicated a significant association with the visual field change in open angle glaucoma eyes.

Maculopathy from Red Laser Pointer

PURPOSE: To report a case of maculopathy following exposure to a red laser pointer beam. PATIENT AND METHODS: A 12-year-old boy visited our clinic due to decreased visual acuity in the right eye after 2 months after exposure to a red laser pointer beam for 10 to 20 seconds at a distance of 3 m. RESULTS: Uncorrected visual acuity was 0.1 and 0.9 in the right and left eyes, respectively. The best corrected visual acuity of the right eye was 0.15. Upon funduscopic examination, a yellowish degeneration was observed in the macular area. Fluorescence angiography showed hyperfluorescent window defect that may have been a retinal pigment epithelial defect related to laser pointer exposure. There were no specific findings in electroretinogram, and the boundary between the photoreceptor and retinal pigment epithelium was ambiguous as determined by optical coherence tomography. A Humphrey automated visual field test revealed generalized central field defect, although his cooperation was not sufficient. CONCLUSIONS: Red laser pointer should be used carefully, as their misuse can result in retinal damage, especially in inadequately used macula.