CORRELATION BETWEEN MEAN VISUAL-FIELD LOSS AND MORPHOMETRIC OPTIC DISK VARIABLES IN THE OPEN-ANGLE GLAUCOMAS

PURPOSE: To correlate morphologic changes of the optic disk with. mean visual field defect in glaucoma, METHODS: Color optic disk photograph s of 302 patients with primary open-angle glaucoma, 53 patients with p seudoexfoliative glaucoma, and 55 patients with normal-pressure glauco ma were morphometrically evaluated The data were correlated with mean visual held defect, RESULTS: The correlation between mean visual field defect: and neuroretinal rim area was similar to a logarithmic functi on, The visual held deteriorated slightly in the early stage and marke dly in the advanced stages of glaucoma, A discrepancy between normal v isual field and abnormal optic disk occurred more often in young than in old patients. Neuroretinal rim shape, total rim area, and rim area in the temporal. inferior and temporal superior disk sectors correlate d best. with mean visual field loss, Alpha and beta zones of peripapil lary atrophy and diameter of retinal arterioles were less clearly corr elated, Calculated rim variables that were corrected for optic disk ar ea did not markedly improve the correlation coefficients Zn eyes with normal visual fields, rim shape was the most important disk variable f or detecting glaucomatous optic nerve damage, There were no patients w ith glaucomatous visual field loss and an unremarkable optic disk, CON CLUSIONS: In early glaucoma, changes are more marked in optic disk app earance than in the visual field, suggesting that, at least for some p atients, for early glaucoma diagnosis, optic disk appearance is more i mportant than perimetry, whereas for follow-up examination, perimetry may be more useful than optic disk morphometry, The most useful planim etric optic disk parameters are neuroretinal rim shape and rim area.