Retinal nerve fiber layer defect patterns in primary angle-closure and open-angle glaucoma: a comparison using optical coherence tomography.

PURPOSE: To compare the patterns of retinal nerve fiber layer (RNFL) thickness loss in primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) using optical coherence tomography (OCT).

METHODS

Forty-three participants with PACG and 60 with POAG underwent fast RNFL thickness measurement by OCT. Eyes were classified according to the visual field mean deviation (VF-MD) into mild (>-8 dB), moderate (-8 dB to >-16 dB), and advanced (≤ -16 dB) glaucoma subgroups. The raw RNFL thickness data were compared with data from the Thai normative database.

RESULTS

Mean (SD) age was 67.0 (9.6) and 64.1 (11.6) years in the PACG and POAG groups, respectively (P = 0.19). In the mild subgroups, a focal RNFL thickness loss was found in the inferior area in the POAG group, but not in the PACG group. The RNFL defect involved sectors 1, 6, and 7 in the moderately advanced disease subgroups of both PACG and POAG and extended through almost all sectors in the advanced disease subgroups. The deepest RNFL defect, -17.25 μm, was found in sector 6 of the mild POAG subgroup, compared with -8.78 μm in the PACG group (P = 0.04). The number of affected points in each sector in the mild subgroups was greater in the POAG group than in the PACG group.

CONCLUSION

Participants with mild POAG had deeper and more localized RNFL defects than did participants with PACG. The pattern was similar in participants with moderate or advanced disease.