Original article
Prevalence, Features, and Severity of Glaucomatous Visual Field Loss Measured With the 10-2 Achromatic Threshold Visual Field Test

https://doi.org/10.1016/j.ajo.2016.05.003Get rights and content

Purpose

To investigate the clinical characteristics of 10-2 visual field defects in subjects with a diagnosis of glaucoma or glaucoma suspicion.

Design

Prospective, observational cohort study.

Methods

From participants enrolled in an ongoing glaucoma research study at our institution, we identified 354 eyes in 180 subjects (97 with primary open-angle glaucoma, 83 with glaucoma suspicion) who had 2 or more reliable 24-2 and 10-2 visual field tests and good-quality spectral-domain optical coherence tomography (SDOCT) scans. Eyes with macular pathology, significant cataract, or nonglaucomatous vision loss were excluded. We applied previously published cluster criteria to define 10-2 visual field loss, and then calculated prevalence, location, severity, and pattern of 10-2 visual field loss as well as its relationships with various functional and structural parameters.

Results

Repeatable 10-2 visual field defects were present in 89 of 180 subjects (49%) and usually exhibited an arcuate or nasal pattern. In eyes with no, mild, moderate, and advanced 24-2 visual field loss, 15 of 236 (6%), 49 of 67 (73%), 25 of 26 (96%), and 25 of 25 (100%) had 10-2 visual field defects, respectively. Of the 114 eyes with 10-2 visual field loss, 93 (82%) demonstrated abnormal points within the central 10 degrees of the 24-2 visual field test. Mean defect on the 10-2 and 24-2 tests was highly correlated (r2 = 0.72).

Conclusions

Although central VF loss appears to be common in glaucoma and may have an important role in glaucoma management, additional study is warranted to more definitively determine the optimal methods to detect presence, severity, and functional impact of central glaucomatous visual field loss.

Section snippets

Methods

This study adhered to the tenets of the Declaration of Helsinki, conformed to HIPAA regulations, and was approved by the Albuquerque VA Medical Center Institutional Review Board. All subjects for this observational investigation were participating in a prospective, ongoing, longitudinal glaucoma research study at the Albuquerque VA Medical Center, and each provided informed consent prior to study participation. General enrollment criteria included: age ≥40 years; open, normal angles in each eye

Results

Westudied 354 eyes of 180 subjects with the following diagnoses: POAG (n = 97), OH (n = 54), and GS (n = 29). Descriptive characteristics stratified by diagnosis are shown in Table 1. Repeatable 10-2 visual field loss was identified in 89 of 180 subjects (49%), with 64 showing 10-2 defects in 1 eye and 25 showing 10-2 defects in both eyes. Of the 89 subjects with 10-2 field loss, corresponding clinical diagnoses were POAG (n = 84), OH (n = 4), and GS (n = 1).

When using eye as the unit of

Discussion

Reproducible glaucomatous visual field loss in this study was as common on the 10-2 test (89 subjects, 114 eyes) as on the 24-2 test (87 subjects, 118 eyes). Most subjects with 10-2 field loss carried a diagnosis of POAG, and the presence and severity of 10-2 field loss was highly correlated with 24-2 visual field results. Nearly every subject (98%) with moderate or advanced 24-2 visual field loss exhibited a 10-2 defect, while 82% of subjects with mild 24-2 field loss and 12% of subjects

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