Navigating the structure/function divide in vision is often a diagnostic challenge. Documenting function is subjective and, as such, not as precise as monitoring structure. However, modern equipment such as spectral domain OCT are helping to bridge the gap by giving clinicians the ability to image layers of the retina connected with the visual functioning—according to a study in the Journal of Glaucoma, it’s working.

The study looked into the relationship between central visual fields (VF) and macular parameters gathered using SD-OCT and shows several of those parameters have a statistically significant relationship with function, the researchers say. Even after the circumpapillary retinal nerve fiber layer (cpRNFL) had reached the measurement floor, the biomarkers, especially in the nasal macular region, reliably correlated with central VF sensitivity.

The South Korean researchers looked at 68 eyes from 68 advanced glaucoma patients with an average cpRNFL thickness of 57μm or less. They used SD-OCT for macular imaging and performed 10-2 Humphrey VF for each patient to determine the relationship between central VF and various macular parameters.

Specifically, significant correlations were found between the central VF and superonasal macular ganglion cell-inner plexiform layer thickness, inner nasal macular thickness and outer nasal macular thickness. The team found no significant correlations between the VF and other cpRNFL thickness parameters.

Sun Sung M, Heo H, Woo Park S. Structure-function relationship in advanced glaucoma after reaching the RNFL floor. J Glaucoma. September 25, 2019. [Epub ahead of print.]