April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Patient Perception of Glaucomatous Visual Field Loss Associated with Disease Severity
Author Affiliations & Notes
  • Kenji Fujitani
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
    Icahn School of Medicine at Mount Sinai, New York, NY
  • Sung Chul Park
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Daniel Su
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
  • Joseph L Simonson
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
  • Christopher C Teng
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Jeffrey M Liebmann
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York University School of Medicine, New York, NY
  • Robert Ritch
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Footnotes
    Commercial Relationships Kenji Fujitani, None; Sung Chul Park, None; Daniel Su, None; Joseph Simonson, None; Christopher Teng, None; Jeffrey Liebmann, Carl Zeiss Meditech, Inc. (F); Robert Ritch, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5639. doi:
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    • Get Citation

      Kenji Fujitani, Sung Chul Park, Daniel Su, Joseph L Simonson, Christopher C Teng, Jeffrey M Liebmann, Robert Ritch; Patient Perception of Glaucomatous Visual Field Loss Associated with Disease Severity. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5639.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To investigate patient perception of glaucomatous visual field loss and its association with glaucoma severity using the Amsler grid test.

 
Methods
 

Glaucoma patients with abnormal 10-2 Humphrey visual field (VF) tests within the previous 4 months were enrolled consecutively. Black-on-white Amsler grid tests were administered for each eligible eye at a distance of 30 cm. Patients were asked to outline any perceived scotomas (areas with missing or blurred grid lines) and then describe verbally their perception of the scotomas. Responses and descriptions used by patients were recorded in their own words. Descriptor frequency and association of descriptors with 10-2 VF mean deviation (MD) were analyzed.

 
Results
 

We included 88 eyes of 50 patients (10-2 VF MD = -11.74±8.69 dB; mean age = 67±11 years). Patients used a total of 40 different descriptors (Table 1). Descriptors were classified into categories that incorporated similar effects, resulting in 6 overarching categories: Missing (M), White (W), Blurry (B), Gray (G), Dark/Black (K), and Not aware (N) (Table 1). The frequency order was: M (40%), B (33%), W (27%), G (24%), K (5%), and N (19%). Mean number of descriptor categories per eye was 1.47±0.71 (range, 1-3). Eyes with greater number of descriptor categories had worse VF MD (p<0.001) (Fig 1A). After Missing (M) and Blurry (B) were combined with White (W) and Gray (G) to generate categories ‘MW’ and ‘BG,’ respectively, each eye naturally sorted into one of the following 5 groups: MW (27 eyes; 31%), BG (21 eyes; 24%), combined MW and BG (MW+BG; 19 eyes; 21%), K (4 eyes; 5%), and N (17 eyes; 19%). The MD severity order was K (-21.55±10.44 dB), MW+BG (-16.51±10.32 dB), MW (-12.41±6.79 dB), BG (-11.05±7.03 dB), and N (-3.91±4.05 dB) (p<0.001): ‘Not aware (N)’ eyes had significantly better VF MD than all the other categories (p<0.005), and ‘Dark/Black (K)’ eyes had significantly worse VF MD than all categories (p<0.030) except ‘MW+BG’ eyes (p=0.227) (Fig 1B).

 
Conclusions
 

Patient perception of glaucomatous VF loss within the central 10 degrees varied considerably, with ~1 of 5 eyes recognizing no VF loss and ~1 of 20 eyes perceiving scotomas as dark or black areas. Eyes with greater number of descriptor categories had more advanced glaucoma, and glaucoma severity tendency was ‘Dark/Black’ < other descriptors < ‘Not Aware.’

     
Keywords: 758 visual fields • 641 perception • 496 detection  
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