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Joon Mo Kim, Haksu Kyung, Joseph Caprioli; The Difference Between Initial Paracentral Defect And Initial Nasal Defect Of Standard Automated Perimetry In Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):172.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the factors associated with initial paracentral defects (PD) and initial nasal defect (ND) of standard automated perimetry in open angle glaucoma
We performed a retrospective observational study with 5 years of follow up. On the basis of two consecutive reliable 24-2 SITA standard visual fields, four groups of patients with glaucoma were studied: 1) PD superior, 2) PD inferior, 3) ND superior, and 4) ND inferior. PD was defined as three or more adjacent points with P<2%, or one point or more with P<1% within the central 2 fixation points and its neighbor points (all 6 points). ND was defined as three or more adjacent points with P<2%, or one or more points with P<1% in the nasal peripheral 3 points and its neighbor points (all 6 points). Clinical characteristics and systemic factors were analyzed from medical records among the four groups to detect associated factors.
One hundred twenty seven eyes were analyzed. The PD superior showed a significant association with disc hemorrhage, low maximum IOP (17.33 mmHg ± 3.58), and low IOP variation (7.59 mmHg ± 3.05) (p<0.001, for all). Among systemic factors considered, hypertension showed a negative association with PD superior (p=0.05). Peripapillary atrophy showed borderline significance with PD superior (p=0.051). There were no significant differences in age, gender, family history of glaucoma, DM, refractive error, central corneal thickness, axial length or disc area.
Patients with a superior PD had difference characteristics than those with other patterns of defects. Especially, disc hemorrhage was closely associated with PD superior. These findings may help clinicians identify and manage patients at early central visual field loss.
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