A Comparison Among Microperimetry, Standard Automated Perimetry and Spectral Domain Optical Coherence Tomography in the Evaluation of the Macula in Glaucoma Eyes with Hemifield Defects

INTRODUCTION: To evaluate the correlation between macular integrity assessment (MAIA) and standard automated perimetry (SAP) in detecting macular function damage in glaucoma and to explore the relationship between macular structure and functional damage by using spectral domain optical coherence tomography (SD-OCT). METHODS: This was a cross-sectional study. Seventy patients with glaucoma, with hemifield defects verified by Humphrey 24-2 examination, and 60 normal subjects underwent Humphrey 10-2 and MAIA expert 10-2 examinations. Patients with glaucoma with normal hemifields, as detected by SAP, were divided into a normal hemifield group and a visual field (VF) defect group. The difference in the retina and ganglion cell complex (GCC) thicknesses was analyzed between the abnormal and normal hemifields. RESULTS: Among the 70 glaucoma eyes, the results of MAIA and SAP were consistent for 66 (66/70, 94.3%). The others showed SAP hemifield defects, while MAIA was normal (4/70, 5.7%). There was a good correlation of the mean sensitivity between MAIA and SAP (P < 0.001). There also was a good correlation between the mean threshold of MAIA and the mean deviation (MD) of SAP (P = 0.008, r = 0.507). Among the patients with glaucoma with a normal hemifield, MAIA showed abnormal results in 50 eyes (50/66, 75.8%), which was consistent with the changes in the inner retina and GCC thicknesses. Meanwhile, MAIA showed normal results; there were no significant differences between patients with glaucoma and the normal group in the thicknesses of the inner retina and GCC. CONCLUSION: MAIA and SAP have good consistency in detecting macular dysfunction. MAIA can also identify abnormal VFs in the macular regions that may not be detected by SAP, which is consistent with the changes in the GCC thicknesses, suggesting that there may be central VF damage in patients with glaucoma that has not been previously identified.