Correlation Between Central Visual Function And Paramters Of Neuroretinal Rim Measured With HRT-Ⅱ In Elderly Patients With Primary Glaucoma

Part one:Correlation between low contrast visual acuity and parameters of neuroretinal rim measured with HRT-II and macular threshold in elderly patients with primary glaucomaObjective To investigate the change of low contrast visual acuity and the correlation between low contrast visual acuity and temporal optic disc parameters measured with HRT—Ⅱand macular threshold in elderly patients with primary glaucoma.Methods 88 eyes of 46 elderly patients with primary glaucoma and 40 eyes of 23 elderly healthy subjects with age and sex mathched were enrolled in this study. The glaucomatous patients were measured with the central 30-2 and macular threshold perimetry (MTP) of Humphrey field analyzer-750i. They were further divided into two groups according to the mean defect (MD) of visual field 30-2:23 cases(45eyes)in the early glaucoma group and 23 cases (43 eyes) in the moderate and severe glaucoma group. The rim area(RA) and rim volume(RV) of the temporal sector of the optic disc in the patients of two glaucoma group were tested with HRT—Ⅱ. The corrected visual acuity at 100%、25%、10% and 5% contrast levels in bright background were measured with a multi-function visual acuity analyzer in all patients in glaucoma group and the healthy subjects in the control group. The corrected visual acuity at 25%、10% and 5 % contrast levels were compared among the control group and the two glaucoma group. The correlations between the corrected visual acuity at the three low contrast levels and the temporal RA and RV tested with HRT—Ⅱwere evaluated in the two glaucoma group seperately;while the correlations between the corrected visual acuity at the three low contrast levels and the mean sensibility (MS) of MTP were also evaluated in the two glaucoma group seperately.Results There was statistically significannt difference in the corrected visual acuity at 25%、10% and 5% contrast levels among the three clinical groups (P<0.05); Though the corrected visual acuity at every low contrast levels in the early glaucoma group was lower than that in the control group, there was no statistically significannt difference between the two group(P>0.05). the corrected visual acuity at every low contrast levels in both the control group and the early glaucoma group were significantly better than that in the moderate and severe glaucoma group (P<0.05); In the early glaucoma group, The correlations between the corrected visual acuity at 25% contrast level and temporal RV (r=-0.301, P<0.05) were statistically significannt. The correlations between the corrected visual acuity at 25% and 10% contrast level and the MS of MTP (r=-0.307; r=-0.298, P<0.05) were statistically significannt. In the moderate and severe glaucoma group, the correlations between the corrected visual acuity at 10% and 5% contrast level and temporal RA(r=-0.361; r=-0.318, P <0.05) and RV (r=-0.303; r=-0.377, P<0.05) were statistically significannt. The correlations between the corrected visual acuity at 10 % and 5% contrast level and the MS of MTP (r=-0.314; r=-0.397, P<0.05) were statistically significannt.Conclusions The visual acuity at low contrast levels decline in elders with advanced primary glaucoma. The visual acuity at different contrast level correlated significanntly with the macular threshold and the rim area(RA) and/or rim volume(RV) of the temporal sector of the optic disc measured with HRT—Ⅱin early or moderate and severe glaucomatous patients. The measurement of low contrast visual acuity may be helpful for assessing the damage and the progression of central visual function of patients with glaucomaPart two:Correlation between macular threshold and parameters of neuroretinal rim measured with HRT-Ⅱin elderly patients with primary glaucomaObjective To study the change of the macular threshold in different period of primary glaucoma in elderly patients and investigate the correlation between macular threshold and temporal optic disc parameters measured with HRT—Ⅱin elderly patients with primary glaucoma.Methods with age and sex mathched,97 eyes of 51 elderly patients、40 eyes of 22 young patients with primary glaucoma and 40 eyes of 23 elderly healthy subjects were enrolled in this study. Humphrey field analyzer-750i was used to test the central 30-2 and macular threshold perimetry (MTP)in the glaucomatous patients. The elderly patients were further divided into two groups according to the mean defect (MD) of central 30-2 perimetry:23 cases(45eyes)in the early glaucoma group and 28 cases (52 eyes) in the moderate and severe glaucoma group. The rim area(RA) and rim volume(RV) of the temporal sector of the optic disc in the patients of three glaucoma group were tested with HRT—Ⅱ. The mean sensibility of MTP were compared among the control group and the two glaucoma group of the elderly patients.The correlations between the mean sensibility of MTP and the temporal RA and RV tested with HRT—Ⅱwere evaluated in the two glaucoma group of the elderly patients seperately;while the correlations between the mean sensibility (MS) of MTP of the young glaucoma group and the temporal RA and RV were also evaluated.Results There was statistically significannt difference in the MS of MTP among the two glaucoma groups of the elderly patients and the control group (P<0.05); The MS of MTP of the elderly patients in the early glaucoma group was lower than that in the control group, there was statistically significannt difference between the two group(P<0.05). There was no correlations between the MS of MTP and temporal RA and RV in both the control group and the early glaucoma group of the elderly patients. The the MS of MTP of the elderly patients in the early glaucoma group and the control group were significantly better than that in the moderate and severe glaucoma group (P<0.05); The MS of MTP of the moderate and severe glaucoma group were significanntly correlated with the temporal RV (r=0.308, P<0.05), while there was no correlations between the MS of MTP and temporal and RA(P>0.05). There was no correlations between MS of MTP and temporal RA and RV in the early glaucoma group of the young patients Conclusions The mean sensibility of MTP decline in elders patients with the progression of glaucoma. The correlations between the macular threshold and the RV in the temporal sector of the optic disc measured with HRT—Ⅱin the moderate and severe glaucomatous patients were statistically significannt. The measurement of macular threshold perimetry may be valuable for assessing the progression of central visual function of patients with primary glaucoma...