Halil Ates1, Suzan Guven Yilmaz1, Murat Erbezci2 Effects of Peripapillary Nerve Fiber Layer Thickness and Visual Field on Reading Performance in Glaucoma Patients Halil Ates1, Suzan Guven Yilmaz1, Murat Erbezci2 1Ege University Hospital, Ophthalmology Department 2Ophthalmology, Private , Izmir, Turkey INTRODUCTION Glaucoma often deteriorates the quality of life by making daily activities, such as walking, driving and reading, difficult .1,2 Reading is a complex process that requires coordinated eye movement , foveal function and visual information processing within the brain, and, thus, reading ability cannot be assessed by measurement of visual acuity or visual field test alone. 3 Yet, studies on reading performance in patients with glaucoma are limited. PURPOSE To investigate the effects of peripapillary nerve fiber layer (RNFL) thickness and visual field (VF) on reading speed in patients with open angle glaucoma. MATERIAL and METHOD Thirty-eight patients (M = 15, F = 23; mean age, 64.9 ± 10.2 years) with open angle glaucoma were enrolled in this cross-sectional, comparative, non-interventional study. Patients with visual acuity less than 0.7 and who had additional ocular pathology were excluded. All patients underwent SITA-standard 24-2 Humphrey VF testing and peripapillary RNFL thickness measurement by Topcon SD-OCT. Reading performance was examined by the Turkish version of the International Reading Speed Test (IReST) (Figure-1) and were compared to that of age-matched normal subjects (n=37). Effects of RNFL thickness and VF parameters on reading speed in better eye (with least VF damage) of glaucoma group were investigated. RESULTS Demographic data and clinical characteristics of patients are presented in Table-1. Reading speed was significantly lower in glaucoma group when compared with the normal subjects (102.5±35.0 and 133.1±13.4 words/sec; respectively, p<0.05 by independent t-test). Mean RNFL thickness in the better eyes of glaucoma patients were 90.1±17.9 (36-126)µ and VFI, MD, PSD, progression rate of VF were 87.7±19.4, -6.1±6.5 dB, 4.5±4.7 dB, 0.7±0.9 dB/year; respectively (Table-2). There was strong positive correlation between reading speed and superior and nasal RNFL thickness values in the better eyes with glaucoma (r=0.537, r=0.360; respectively, p<0.05 by Pearson's correlation analysis). The strongest correlation between reading speed and VF parameters was observed with progression rate and VFI (r=-0.542 and r=0.497; respectively, p<0.05 by Pearson's correlation analysis). This parameters were followed by MD and PSD with lower significance (r=483 and r=-0.426; respectively, p<0.05 by Pearson's correlation analysis). Table-2. RNFL and VF Parameters of Both Eye in Study Group Table-1. Demographic data and clinical characteristics of patients Figure-1. Turkish version of the International Reading Speed Test (IReST) DISCUSSION Near vision tasks such as reading are the most valued visual function amongst subjects with glaucoma. It has been reported that subjects with bilateral glaucoma were almost 5 times more likely to report severe difficulty with near activities than subjects without glaucoma.5,6 This confirms several clinic-based studies that demonstrate more vision-related difficulty with near vision tasks in the presence of glaucoma-related VF loss. 7 In our study, the reading performance deteriorated even in glaucoma patients with preserved visual acuity. Superior and nasal RNFL thicknesses, and all VF parameters were associated with reading speed of the better eye. REFERANCES 1 Aspinall PA, Johnson, ZK, Azuara-Blanco A, et al. Evaluation of quality of life and priorities of patients with glaucoma. Invest Ophthalmol Vis Sci. 2008;49:1907–15. 2. Sewo Sampaio PY, Ito E. Activities with higher influence on quality of life in older adults in Japan. Occup Ther Int. 2012;20:1–10. 3. Murata H, Hirasawa H, Aoyama Y, et al. Identifying areas of the visual field important for quality of life in patients with glaucoma. PLoS One. 2013;8:1–7. 4. Cummings RW, Rubin GS. Reading speed and saccadic eye movements with an artifical paracentral scotoma. Invest Ophthalmol Vis Sci. 1993;34:1318. 5. Ramulu P. Glaucoma and disability: which tasks are affected, and at what stage of disease? Curr Opin Ophthalmol. 2009;20:92–8. 6. Freeman EE, Munoz B, West SK, et al. Glaucoma and quality of life: the Salisbury Eye Evaluation. Ophthalmology 2008;115:233–238 7. Nelson P, Aspinall P, O’Brien C. Patients’ perception of visual impairment in glaucoma: a pilot study. Br J Ophthalmol.1999;83:546–52.