They don’t call glaucoma the “sneak thief of sight” for nothing.1 Glaucoma patients usually don’t notice changes to their vision for some time, but it’s slowly invading their peripheral vision. Even optometry’s best in-office functional testing can’t match the precision of an in-person exam with imaging of the optical nerve, new research shows.2

According to a Los Angeles research team, structural changes can be detected more frequently than functional ones.2 Measurements of both structure and function are required for optimal detection of central progression, the investigators concluded.2 They looked at 116 eyes with at least three years of follow-up and five or more years worth of macular OCT images and central visual field tests. The researchers estimated rates of change by examining the full macular thickness, ganglion cell complex, ganglion cell-inner plexiform layer and ganglion cell layer.2

They found that ganglion cell complex measures demonstrated the highest overall longitudinal structural/functional correlations. Significant structural worsening was more frequently detected than functional deterioration at three and five years out.2 

1. Prevent Blindness. Glaucoma Sneak Thief of Sight Continues to Affect Vision of Millions of Americans. Accessed February 6, 2020.

2. Mohammadzadeh V, Rabiolo A, Fu Q, et al. Longitudinal macular structure-function relationships in glaucoma. Ophthalmol. January 22, 2019. [Epub ahead of print].