LAUSR

PURPOSE To investigate association between the vertical position of the central retinal vessel (CRV) within the optic nerve head (ONH) and site of visual field defects (VFDs) in glaucoma. DESIGN Cross-sectional study. METHODS Vertical position of the CRV was identified in 134 glaucoma eyes and 61 normal eyes at the point at which CRV exits lamina cribrosa (LC) onto the ONH surface using spectral-domain optical coherence tomography (exit position). It was also identified at the entry point into the LC from retro-laminar ONH region (entry position), which was little influenced by glaucomatous LC deformation therefore close to the original position before the glaucoma development. They were compared among glaucoma eyes with different sites of VFDs, and between glaucoma and normal eyes. RESULTS In glaucoma eyes, the entry position of the CRV was in the superior ONH region in 63.0% of eyes with superior VFDs and in the inferior ONH region in 97.8% of eyes with inferior VFDs (P < 0.0001). The exit position exhibited similar percentage. The vertical CRV position was not significantly different between glaucoma and normal eyes both at the entry and exit positions. CONCLUSIONS Eyes with CRVs in the superior ONH region were significantly more likely to form VFDs in the superior hemifields, and vice versa. The vertical position of the CRV was little altered by the development of glaucoma. Original position of the CRV before the development of glaucoma may influence regional susceptibility to glaucomatous stress and may be useful in predicting initial site of VFDs.