MAPPING STRUCTURAL DAMAGE OF THE OPTIC DISK TO VISUAL-FIELD DEFECT INGLAUCOMA

PURPOSE: To evaluate the relation between the location of focal visual held defects and optic disk damage in eyes with glaucoma by short wav elength automated perimetry and confocal scanning laser ophthalmoscopy . METHODS: In 14 patients (14 eyes) with open-angle glaucoma, focal op tic disk damage, and focal visual field loss, we obtained visual field s with short-wavelength automated perimetry. The short wavelength auto mated perimetry visual field was divided into 21 zones, representing r etinal nerve fiber layer arcuate bundles. Test points were compared wi th a normative database. The optic disk was assessed with a confocal s canning laser ophthalmoscope, Optic disk measurements were calculated in 10-degree sectors and compared with a normative database using a ne w measure, the rim area ratio, which adjusts for individual difference s in disk size. RESULTS: The mean number (+/-SD) of damaged visual fie ld zones was 3.9 (+/-1.9), and the mean number of damaged rim sectors was 5.0 (+/-2.9). Focal defects on the optic disk and on short-wavelen gth automated perimetry were topographically related with specific dam aged visual field zones corresponding to specific damaged rim sectors. CONCLUSIONS: In patients with open-angle glaucoma with focal optic di sk damage and focal visual field loss, defects in optic disk and short -wavelength automated perimetry are topographically related. The rim a rea ratio can be used to identify focal optic nerve defects.