Retinal pigmentepithelium (rpe) alterations correspond to retinal nerve fiber layer (rnfl) degeneration in glaucoma

Purpose A close interaction between neurosensory retina and the retinal pigmentepithelium (RPE) is a prerequisite for normal vision. Glaucomatous damage is characterized by neuroretinal degeneration. As a result, an imbalanced interaction exists. However, there is only limited evidence regarding RPE involvement in glaucoma patients’ eyes. This study investigates the correlation between retinal nerve fiber layer (RNFL) thickness and RPE alterations as detected by widefield fundus autofluorescence (FAF). Methods Peripapillary RNFL thickness was quantified by optical coherence tomography (OCT). The six corresponding retinal areas were defined by a standardized grid and FAF intensity/irregularities were assessed and correlated to RNFL measurements. Results 84 glaucomatous eyes were investigated. A correlation between RNFL thickness and standardized FAF in the corresponding topographic retina segments was observed. Correlation coefficients ranged between -0.12 to 0.35 and were statistically significant in the temporal inferior central field (r=0.35, p=0.02) and the temporal inferior peripheral field (r=0.31, p=0.04). Conclusion This study provides early evidence that in glaucoma RNFL degeneration may be accompanied by corresponding RPE alterations