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A Journal on Ophthalmology
Minerva Oftalmologica 2012 June;54(2):59-67
Anatomical and functional assessment of damage in the eyes of glaucomatous patients
Montorio D., Della Guardia C., Minervino C., Cesarano I., Chiariello Vecchio E., Cennamo G. L.
Dipartimento Assistenziale di Oftalmologia, Università degli studi “Federico II”, Napoli, Italia
Aim. Value morphological-structural (mean RNFL thickness, mean GCC thickness) and functional (mean deviation, pattern standard deviation) correlation in glaucomatous disease. Further we wanted to demonstrate the diagnostic value of parameters: mean RNFL thickness, mean GCC thickness, mean deviation, pattern standard deviation in the evaluation of anatomical and functional changes in different stages of glaucoma.
Methods. Forty-nine eyes of 30 patients with diagnosis of open angle glaucoma were divided into 4 groups: Group 1:16 eyes of 9 pre-perimetric patients; Group 2: 13 eyes of 10 perimetric patients (early glaucoma); Group 3: 7 eyes of 6 perimetric patients (moderate glaucoma); Group 4: 13 eyes of 10 perimetric patients (severe glaucoma). Retinal structural changes have been analyzed using the following parameters: mean RNFL thickness and mean GCC thickness measured by Fourier Domain OCT, while retinal functional changes have been analyzed using parameters mean deviation and pattern standard deviation, measured by visual field. Relation between quantitative (mean RNFL thickness, mean GCC thickness) and qualitative parameters (mean deviation, pattern standard deviation) has been evaluated using linear and quadratic regression analysis; the study has been completed using analysis of variance (ANOVA). The diagnostic value of analyzed parameter among the different stages of glaucomatous disease has been determined using independent t-test. In addition, all glaucomatous patients eye have been compared with 20 eyes of 10 healthy patients for each parameter studied analyzed with independent t-test.
Results. The parameters mean RNFL thickness and mean GCC thickness, mean deviation and pattern standard deviation have shown an evident diagnostic picture of an important anatomic-functional loss passing from the early to the advanced stage of glaucoma (significance P<0.05). In addition there was a significant correlation between the anatomical and functional damage in glaucomatous patients.
Conclusion. The examination of retinal nerve fiber, ganglion cells complex, represents the new vanguard in glaucomatous diagnostic field, consenting the possibility of doing an early diagnosis and a good follow up to morphological and anatomical changes of pathology.