Demographic, ocular factors relevant to RNFL measurements in patients with glaucoma

Posted on

A study found that accounting for demographic and anatomical ocular factors improved the correlation between retinal nerve fiber layer (RNFL) thickness and visual field (VF) parameters in patients with glaucoma. Adopting compensated RNFL data in clinical practice can improve glaucoma diagnosis and monitoring efforts, the authors concluded.

The cross-sectional study included 600 eyes of 412 patients with glaucoma. In this study, compensated RNFL thickness accounted for:

  • Age
  • Refractive error
  • Optic disc parameters
  • Retinal vessel density

The greatest correlation between measured RNFL and mean deviation VF was the superior arcuate sector (0.49; 95% CI, 0.37-0.59). When using the compensated RNFL data, this correlation increased “substantially” (0.62; 95% CI, 0.52-0.70; P<.001).

Just 61% of the VF locations showed a significant relationship between structural and functional aspects using measured RNFL data, and this increased to 78% with compensated RNFL measurements. In the 10°-20° VF region, the slope below the breakpoint for compensated RNFL thickness demonstrated a stronger correlation (P<.001) than measured RNFL (P=.688).

“This indicates that creating structure-to-function maps that consider anatomical variances may aid in identifying localized structural and functional loss in glaucoma,” the authors concluded.


Chua J, Chong R, Wong TT, et al. Enhancing the structure-function relationship in glaucoma using anatomical compensation of retinal nerve fibre layer. Br J Ophthalmol. 2024:bjo-2023-324792. doi:10.1136/bjo-2023-324792