May 2006
Volume 47, Issue 13
ARVO Annual Meeting Abstract  |   May 2006
Visual Fields in the Ischemic Optic Neuropathy Decompression Trial (IONDT): Baseline and Change Over Time
Author Affiliations & Notes
  • S.E. Feldon
    Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, NY
  • R.W. Scherer
    Bloomberg School Public Health, Johns Hopkins University, Baltimore, MD
  • L. Levin, III
    Ophthalmology, Keck/USC School of Medicine, Los Angeles, CA
  • S.E. Kelman
    no affiliation, Baltimore, MD
  • K. Dickersin
    Bloomberg School Public Health, Johns Hopkins University, Baltimore, MD
  • Footnotes
    Commercial Relationships  S.E. Feldon, None; R.W. Scherer, None; L. Levin, None; S.E. Kelman, None; K. Dickersin, None.
  • Footnotes
    Support  NEI Cooperative Agreements: EY09550–57, EY09565–72, EY09575–76, EY09578–79, EY09584, EY09598–99, EY09582, EY09626, EY09608, EY09545. Other support : RPB Challenge Grant to U of Rochester (Dr Feldon)
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 1087. doi:
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    • Get Citation

      S.E. Feldon, R.W. Scherer, L. Levin, III, S.E. Kelman, K. Dickersin; Visual Fields in the Ischemic Optic Neuropathy Decompression Trial (IONDT): Baseline and Change Over Time . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1087.

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

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Background: : The IONDT included a randomized trial and nonrandomized study of 258 and 160 patients, respectively, with newly diagnosed non–arteritic ischemic optic neuropathy (NAION). Enrolled randomized eyes had acuity of ≤ 20/64 and non–randomized eyes of > 20/64 or refused randomization. Visual fields were measured at baseline, and at 6 and 12 months follow–up, using the Humphrey Field Analyzer (24–2 and size III stimulus).

Purpose: : To develop a computerized classification system to analyze fields of NAION patients and to describe visual field defect pattern and severity at baseline and change in these parameters at follow–up.

Methods: : We developed and validated a computerized classification system to categorize NAION visual fields by incorporating defect and severity definitions agreed upon by 6 neuro–ophthalmologists into a rule–based system run on Excel®. We used this system to categorize IONDT visual field defects and severity at baseline, and at 6 and 12 months follow–up. We compared baseline visual field pattern and defect severity, and change in pattern and severity over time, by treatment group, visual acuity, age, and co–morbidities.

Results: : At baseline, 70% (162/229) of fields from randomized eyes had a central scotoma combined with a superior and/or inferior defect. Those of non–randomized eyes had superior and/or inferior defects without central involvement (92/147; 62.6 %). Eyes with more severe defects or with central scotomas usually had worse visual acuity, and older patients (≥ 65 years) had more severe defects than younger patients (180/220; 81.8% versus 108/156; 69.2%; p = .002). We observed significant changes in the defect distribution within the field from baseline to 6 and 12 months (p = 0.003 and p = 0.02, respectively) for randomized, but not non–randomized eyes. Superior and inferior altitudinal defects were less severe at follow–up than at baseline for both groups. Overall, 74% of fields stayed the same or had improved at 6 months and 76% at 12 months with a positive association between change in acuity and change in the field (p < 0.001 at 6 months and p = 0.01 at 12 months; Kendall’s tau–b).

Conclusions: : The most common baseline visual field defect patterns found in IONDT eyes were superior and inferior defects with or without central scotomas. About 75% of IONDT visual fields showed improvement or no change at 6 and 12 months.

Keywords: neuro-ophthalmology: optic nerve • clinical (human) or epidemiologic studies: outcomes/complications • visual impairment: neuro-ophthalmological disease 

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