Association of anatomical factors of the papillomacular bundle with glaucomatous progression of the central visual field

Abstract

The evaluation of the central visual field (CVF) should be detailed during the follow-up of patients with primary open-angle glaucoma (POAG). This region is related to several of the main visual functions required for human interaction with the environment and has a direct impact on quality of life. The papillomacular bundle (PMB) corresponds to the set of bundles of axons of the retinal ganglion cells that carry information from the macular region and is one of the last regions to be affected in the perimetric progression in a significant part of the glaucomatous patients. Thus, at least in part, this region is frequently spared until moreadvanced stages of the POAG; however the reasons for this particular finding are not yet fully understood.This study is aimed to identify anatomical variables that may interfere with greater susceptibility to central glaucomatous losses, by correlating them with the locations more affected in the perimetric area corresponding to the PBM. Thus, the objective of this study will be to compare the disc-foveal angle, the relative angulation of the main vascular trunks in relation to the median raphe, as well as anatomical differences in the temporal portion of the lamina crivosa between patients with advanced POAG with or without perimetric changes in the projection area of PMB at the CVF.Our results may demonstrate anatomical relationships detected by retinography and / or optical coherence tomography that would be associated with major visual field defects in this region, contributing to the understanding of the glaucomatous lesion pathophysiology. In addition, depending on the results obtained, both innovative structural and functional measures and, eventually, new therapeutic approaches may be proposed for the managementof patients with advanced POAG.