Short-Wavelength Automated Perimetry Results Are Correlated with Optical Coherence Tomography Retinal Nerve Fiber Layer Thickness Measurements in Glaucomatous Eyes Ce ´sar A. Sa ´nchez-Galeana, MD, Christopher Bowd, PhD, Linda M. Zangwill, PhD, Pamela A. Sample, PhD, Robert N. Weinreb, MD Purpose: To determine the relationship between retinal nerve fiber layer (RNFL) thickness measured using optical coherence tomography (OCT) and short wavelength–sensitive visual function measured using short- wavelength automated perimetry (SWAP). Design: Retrospective observational case series. Methods: Subjects were recruited from the longitudinal University of California, San Diego, Diagnostic Innovations in Glaucoma Study and included 29 glaucoma patients with OCT imaging and reliable SWAP visual field (VF) testing within a 6-month window. Main Outcome Measures: Correlations between deviation from normal (thinner than 97.5% of normal) RNFL measurements taken at 30° sectors (12 sectors described as clock hours) and SWAP average pattern deviation within 21 VF zones were determined. The number of OCT-measured RNFL sectors outside of normal limits and the number of VF zones outside of normal limits also were compared. Results: The OCT nerve fiber layer thickness was outside of the normal limits in at least 1 sector in 26 (89.6%) patients. Twenty-eight (96.5%) patients had at least 1 SWAP VF zone outside of normal limits. Optical coherence tomography sectors 6-o’clock, 7-o’clock, and 8-o’clock (inferior and inferotemporal) and SWAP VF zones 13, 14, and 16 (superior hemifield central and arcuate areas) were the most frequently damaged. In general, the strongest R 2 associations were between inferior and inferior temporal RNFL sectors (e.g., 6-o’clock, 7-o’clock) and superior nasal/arcuate VF zones (e.g., zones 13, 14, 15) and between superior and superior temporal RNFL sectors (e.g., 12-o’clock, 11-o’clock) and inferior central and arcuate VF zones (e.g., zones 5, 6, 7) (R 2 range = 24.3%–37.3%, all Ps  0.005). Most nonsignificant associations were found between superior RNFL sectors and superior VF zones. Conclusion: Retinal nerve fiber layer thickness measured with OCT is topographically correlated with glaucomatous VF defects measured with SWAP. Ophthalmology 2004;111:1866 –1872 © 2004 by the American Academy of Ophthalmology. Optical coherence tomography (OCT) provides images of the optic disc and retina, including the retinal nerve fiber layer (RNFL). 1,2 Optical coherence tomography has been successfully used to detect RNFL defects in glaucomatous eyes with standard automated perimetry (SAP) defects. 2–5 Although the sensitivity of SAP for detecting early loss of retinal ganglion cells is somewhat poor, 6 we recently showed that SAP results and OCT results are topographi- cally related in glaucomatous eyes. 7 Some evidence suggests that visual function–specific psychophysical strategies for detecting glaucomatous field defects, such as short-wavelength automated perimetry (SWAP), have greater sensitivity to early glaucoma than standard achromatic automated perimetry, a nondiscrimina- tive method for ganglion cell testing for glaucoma diagno- sis. The ability of SWAP to isolate a specific visual function associated with a subset of retinal ganglion cells might allow it to detect glaucomatous defects earlier and more extensively than SAP. 8,9 Originally received: November 26, 2003. Accepted: April 7, 2004. Manuscript no. 230812. From Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California. Dr Sa ´nchez-Galeana currently is at Vision Care Laser Center, Mexico City, Mexico. Supported by National Institutes of Health, Bethesda, Maryland (grant nos.: EY11008 [LMZ], EY08208 [PAS]). Drs Sample and Weinreb have received research support from Carl Zeiss Meditec, Dublin, California. Correspondence to Robert N. Weinreb, MD, Hamilton Glaucoma Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0946. 1866 © 2004 by the American Academy of Ophthalmology ISSN 0161-6420/04/$–see front matter Published by Elsevier Inc. doi:10.1016/j.ophtha.2004.04.017