Relationhip between tructural abnormalitie and hort-wavelength perimetric defect in eye at rik of glaucoma

PURPOE: To determine the relative prevalence of blue-yellow perimetric defect and tructural abnormalitie of the optic nerve and nerve fiber layer in eye at rik of glaucoma. METHOD: eventy-two eye (of 72 patient) at rik of glaucoma, with normal white-on-white full threhold perimetry, were examined propectively with blue-yellow full-threhold perimetry (Humphrey). tructural evaluation were conducted with qualitative aement of tereocopic color optic dik photograph and monochromatic nerve fiber layer photograph performed independently by three maked examiner (a glaucoma pecialit and two glaucoma fellow), and tatitical analyi of ummary parameter wa obtained with canning confocal laer tomography (abnormal defined a value outide 95% confidence limit etablihed in normal control ubject). REULT: Kappa value for interoberver agreement were 0.64, 0.88, and 0.79 for optic dik evaluation and 0.59, 0.60, and 0.61 for nerve fiber layer evaluation. Thirteen (18%) of 72 eye had blue-yellow abnormalitie. A total of 30 eye (42%) were identified a having a tructural abnormality; 29 (40%) had qualitatively determined optic dik abnormalitie, 21 (29%) had qualitatively determined nerve fiber layer defect, and 26 (36%) had tatitically ignificant tructural abnormalitie. Twelve of 13 eye with blue-yellow defect had a detectable tructural abnormality; all 12 had abnormalitie identified with dik photography, nine with nerve fiber layer photography, and 12 by canning laer tomography. CONCLUION: Clinically detectable tructural abnormalitie frequently coexit with blue-yellow perimetric defect in patient with ocular hypertenion. A ubtantial proportion of patient with ocular hypertenion with normal blue-yellow perimetry ha early detectable glaucomatou tructural abnormalitie.