Adjusting circumpapillary retinal nerve fiber layer profile using retinal artery position improves the structure–function relationship in glaucoma

Abstract

Purpose: To investigate whether correcting the circumpapillary retinal nerve fiber layer (cpRNFL) thickness profile, using retinal artery position and papillomacular bundle tilt, can improve the structure–function relationship in glaucoma patients. Methods: Spectral-domain optical coherence tomography (SD-OCT) and visual field measurements were conducted in 142 eyes of 90 subjects with open angle glaucoma. The SD-OCT cpRNFL thickness profile was corrected for retinal artery position and/or papillomacular tilt in all twelve 30° sectors of the optic disc, and the structure–function relationship against corresponding 30° sectorial retinal sensitivity was investigated by using linear mixed model. Results: Applying a correction to the cpRNFL thickness profile for retinal artery position resulted in a stronger structure–function relationship in all 12 sectors of the optic disc. Furthermore, applying a further adjustment for papillomacular tilt resulted in a further improvement in 9 of 12 sectors. Conclusions: Correcting cpRNFL profile, using the retinal artery position significantly strengthened the structure–function relationship. In most optic disc sectors, using the papillomacular bundle tilt improved cpRNFL thickness measurements.