Relationship between parapapillary atrophy and visual field abnormality inprimary open-angle glaucoma

PURPOSE: To investigate the relationship of parapapillary atrophy measured by confocal scanning laser ophthalmoscopy to visual field sensitivity measu red with standard automated perimetry and short-wavelength automated perime try in patients with primary open-angle glaucoma. METHODS: Forty-seven eyes of 47 primary open-angle glaucoma patients with i ncreased intraocular pressure (greater than or equal to 22 mm Hg) were enro lled. Optic nerve head topography and parapapillary atrophy (beta and alpha zones) were assessed-by confocal scanning laser ophthalmoscopy. Mean devia tion and corrected pattern SD were assessed with standard automated perimet ry and short-wavelength automated perimetry. RESULTS: Beta and alpha zones were found in 23 (49%) and 47 (100%) eyes wit h primary open-angle glaucoma, respectively. The area of beta zone showed s ignificant correlations with MD of standard automated perimetry, corrected pattern SD of standard automated perimetry, and corrected pattern SD of sho rt-wavelength automated perimetry (Spearman r = -0.366, P = .012; r = 0.327 , P = .025; and r = 0.436, P = .002, respectively). The area of alpha zone showed a significant correlation with mean deviation of standard automated perimetry (r = -0.378, P = .009), Mean MD of standard automated perimetry, mean corrected pattern SD of standard automated perimetry, and mean correct ed pattern SD of short-wavelength automated perimetry were significantly wo rse in eyes with beta zone than in eyes without beta zone. CONCLUSIONS: Parapapillary atrophy measured by confocal scanning laser opht halmoscopy, especially beta zone, is associated with glaucomatous visual fi eld loss demonstrated by standard automated perimetry and short-wavelength automated perimetry, (Am J Ophthalmol 1999;127:674-680, (C) 1999 by Elsevie r Science Inc. All rights reserved.).