The Relationship Between Structure And Function In Pre-perimetric,Early And Moderate Primary Open-angle Glaucoma

Objective: Using microperimetry(MP)and optical coherence tomography(OCT)to measure the macular visual sensitivity and visual sensitivity around optic disc,the thickness of GCIPL in macular area,retinal nerve fiber layer around optic disc(RNFL)to investigate the relationship between the structure and function in pre-perimetric、early and moderate primary open-angle glaucoma.Methods:We studied 21 normal patients(40 eyes),29 patients(40 eyes)with pre-perimetric glaucoma and 35 patients(40 eyes)with early and moderate primary open-angle glaucoma.The visual sensitivity of the macular area and the retina around the optic disc was measured by microperimetry.OCT was used to measure the thickness of GCIPL and RNFL in all subjects.The parameters of upper macular visual sensitivity and lower macular visual sensitivity,upper nasal macular visual sensitivity,lower nasal macular visual sensitivity,upper temporal macular visual sensitivity,lower temporal macular visual sensitivity,average macular visual sensitivity,upper visual sensitivity around the optic disc,lower around the optic disc,nasal around the optic disc,temporal around the optic disc,average around the optic disc,upper GCIPL and lower GCIPL,upper nasal GCIPL,lower nasal GCIPL,upper temporal GCIPL,lower temporal GCIPL,average GCIPL,upper RNFL,lower RNFL,nasal RNFL,temporal RNFL,average RNFL were compared in each group.Results: In the pre-perimetric glaucoma group,the visual sensitivity of the macular was positively correlated with the thickness of GCIPL.The visual sensitivity around the optic disc was positively correlated with the thickness of RNFL.The high correlation was found in macularthe upper temporal part(r=0.831).In the glaucoma group,the visual sensitivity of the macular was positively correlated with the thickness of GCIPL.The visual sensitivity around the optic disc was positively correlated with the thickness of RNFL.The high correlation was found in the macular lower temporal part(r=0.829).In the pre-perimetric glaucoma group,except that the AUC value of RNFL on lower(0.69)and nasal(0.58)side was lower than 0.7,RNFL and GCIPL thickness were both more than 0.70.Except that the AUC value of the visual sensitivity around the optic disc on nasal(0.67)side was lower than 0.7,The visual sensitivity AUC values in the macular region and the visual sensitivity AUC values around the optic disk were both more than 0.70.In the glaucoma group,RNFL thickness,GCIPL thickness,the visual sensitivity AUC values in the macular region and the visual sensitivity AUC values around the optic disk were both more than 0.70,and the visual sensitivity AUC(0.90)value of the macular lower temporal part in macular region was the largest and had a high diagnostic efficiency.Conclusion:1.In pre-perimetric,early and moderate primary open-angle glaucoma,the visual sensitivity of the macular region and the visual sensitivity around the optic disk has similar diagnostic significance to GCIPL thickness and RNFL thickness,which can provide an important reference for the early diagnosis and follow-up of glaucoma.2.The structure and function have close relationgship in pre-perimetric、early and moderate primary open-angle glaucoma.3.In pre-perimetric glaucoma,microperimetry can exhibit more tiny visual function damage than Humphrey perimeter,which can provide an important reference for the early diagnosis and follow-up of pre-perimetric glaucoma.