Detecting glaucoma with visual fields derived from frequency-domain optical coherence tomography.

PURPOSE To compare the assessment of glaucomatous damage based on visual fields (VFs) derived from frequency-domain optical coherence tomography (OCT) to actual VFs obtained from static automated perimetry. METHODS A total of 84 eyes from 84 glaucoma patients or suspects and 128 eyes from 128 healthy subjects were included. The retinal ganglion cell (RGC) and retinal nerve fiber layer (RNFL) thicknesses measured with macular and disc RNFL cube scans were combined and decomposed into 48 principal components (PCs). For each eye, an OCT to VF transformation map was built using multiple linear regression (MLR) and the OCT and VF data from the other eyes. Using this transformation map, the combined 24-2- and 10-2-derived VF for this eye was then obtained. RESULTS With 98.0% specificity, the sensitivity of the derived VF reached 78.0% for all hemifields, whereas 74.4% of the actual VF hemifields were classified as abnormal. The agreement between the derived and the actual VFs was 82.2%. For each VF location, the derived VF values were linearly related to the actual values. CONCLUSIONS The derived VF based on the OCT data appears as sensitive as the actual VF for detecting glaucomatous damage. Because the derived and actual VFs should have largely independent sources of variability, the combination of the two should provide a more powerful diagnostic tool.