Macular Retinal Ganglion Cell Complex Damage in the Apparently Normal Visual Field of Glaucomatous Eyes With Hemifield Defects

Purpose: To compare the thicknesses of the macular ganglion cell complex (mGCC), the entire macular retina, and the peripapillary retinal nerve fiber layer (ppRNFL) in the apparently normal visual field of glaucomatous eyes with hemifield defects with thicknesses in normal eyes. In addition, to evaluate the relationship between the structural and retinal sensitivity parameters by standard automated perimetry. Methods: This single institution study included 50 eyes of 50 glaucoma patients with visual field defects restricted to the superior or inferior hemifield, in addition to 25 eyes of 25 normal controls matched for age, sex, and refractive errors. We measured the thickness of the 3 areas of interest using the automatic algorithm of a spectral-domain optical coherence tomography device. We subsequently compared the difference in these values between the defective and normal hemifields. Furthermore, each optical coherence tomography parameter was correlated with the total deviation values of the parameters in the Humphrey visual field corresponding to each hemisphere. Results: The thickness of the mGCC in the normal hemifield of the glaucomatous eyes was significantly less than in normal eyes. In contrast, the total thickness of the macular retinas between the glaucomatous and normal eyes showed no significant difference. In addition, the thicknesses of the mGCC and ppRNFL in the normal hemisphere of the glaucomatous eyes were significantly correlated with the total deviation in the visual field parameters of the corresponding area. Conclusions: In addition to ppRNFL thickness, the mGCC thickness could be a structural parameter for detecting preperimetric glaucoma.