Comparison of Retinal Ganglion Cell Damage in Glaucoma and Retinal Vein Occlusion by Visual Field

PURPOSE: We analyzed and compared retinal ganglion cell damage between patients with glaucoma and those with branched retinal vein occlusion (BRVO). We performed two types of visual field examinations. METHODS: We retrospectively reviewed the medical records of 40 glaucoma eyes and 40 BRVO eyes. We compared the median deviation (MD), the pattern standard deviation (PSD), and sensitivity of damaged visual hemifield from frequency-doubling technology (FDT) C24-2 and standard automated perimetry (SAP) C24-2 visual field tests evaluation. We sought correlations between the MDs and retinal nerve fiber layer thickness as revealed by optical coherence tomography. RESULTS: MDs did not differ between the groups. PSD value was higher in glaucoma patients with FDT C24-2 test (p = 0.022), but no difference between two groups with SAP C24-2 test (p = 0.144). In terms of the sensitivity of the damaged visual hemifield, glaucoma patients had larger areas of damage in the FDT C24-2 test (p < 0.01). In regression analyses, the log R2 values of both tests were higher in glaucoma patients. CONCLUSIONS: Glaucoma patients had a greater damaged visual field area in the FDT C24-2 test than the SAP C24-2 test. The BRVO patients exhibited similar extents of damage in both tests. Thus, the subtypes and distributions of damaged retinal ganglion cells may differ between the conditions, facilitating differential diagnosis.

Associations between Retinal Nerve Fiber Layer Defect and Systemic Indices According to the KNHNES 2010–2012

PURPOSE: To investigate the associations between retinal nerve fiber layer (RNFL) defects and systemic factors in the Korean population. METHODS: Based on data from the 5th Korean National Health and Nutritional Examination Survey (2010–2012), 2,999 non-glaucomatous patients and 424 glaucoma patients were included. We compared body mass index (BMI), blood pressure, and blood test values according to the presence and location of RNFL defects in the groups and analyzed whether these defects were associated with various underlying diseases. RESULTS: In the non-glaucomatous group, RNFL defects were significantly and linearly related with BMI (p = 0.035), systolic blood pressure (p < 0.001), diastolic blood pressure (p = 0.018), fasting blood glucose (p < 0.001), HbA1c (p < 0.001), serum ferritin (p = 0.008), and RNFL defects were also significantly associated with diabetes mellitus (p = 0.001), hypertension (p < 0.001), dyslipidemia (p = 0.003), a history of myocardial infarction or angina (p = 0.037), and migraines (p = 0.004). In the glaucoma group, patients who had superior RNFL defects had a significantly lower systolic blood pressure (p = 0.034) than patients who had inferior RNFL defects. The other systemic indices did not differ significantly between these two subgroups. Superior RNFL defects were significantly associated with diabetes mellitus (p = 0.047) and a history of cerebrovascular accident (p = 0.031). CONCLUSIONS: RNFL defects in both the non-glaucomatous and glaucoma groups were associated with systemic factors. We could identify that the possibility of RNFL defects can be deduced from these systemic abnormalities and active treatment is needed in abnormal systemic condition.