MULTIPLE DEFECTS IN THE RETINAL NERVE-FIBER LAYER IN GLAUCOMA

We investigated the parameters that correlated with multiple defects in the retinal nerve fiber layer in 77 human eyes with normal-tension glaucoma, 110 with chronic high-tension glaucoma, and 102 control eyes. All 187 glaucomatous eyes had a nerve defect that was multiple in 20 cases. Correlation was significant between the multiple defect and the type of defect in the nerve fiber layer (P < 0.002), size of the disc (P < 0.02), and oblique insertion of the disc (P < 0.02), as evaluated by the chi-square test. By multivariate analysis, refractive error was a high-ranking risk factor for multiple defect. Eyes with multiple defects tended to have moderate myopia, a focal nerve fiber layer defect and a small optic disc (category scores 0.0932, 0.0878 and 0.0697) and were less likely to have a diffuse defect in the nerve fiber layer, emmetropia or hyperopia, and a normal disc size (category scores -0.1077, -0.0705, and -0.548). The multiple defect in the retinal nerve fiber in glaucoma was frequently focal and correlated with myopia and a small optic disc.