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J.W. Much, C. Liu, J.R. Piltz–Seymour; Loss of Central Visual Field Is Rare in Treated Patients With End–Stage Glaucoma . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2479.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate further loss of visual field and central visual acuity in patients with end–stage glaucoma as defined by a visual field of 20 degrees diameter or less. Methods: Retrospective review of patients seen in the glaucoma clinic at the Scheie Eye Institute (University of Pennsylvania) from 1992 to present. Patients were identified as having more than one 10–2 visual field test on the Humphrey automated perimeter. Only eyes with a visual field limited to a 20–degree diameter (as verified on a previous 24–2 or 30–2 field test or GVF) were included in the study. Patients were excluded if they had any other disease that might contribute to visual field loss except cataract. Visual acuities and intraocular pressures were recorded. For each visual field, the largest horizontal and vertical diameters were measured in degrees counting only threshold points greater or equal to 10 decibels. Other data recorded include the number of points on the pattern deviation plot with a probability value greater than 5% and the statistical indices of mean deviation (MD) and pattern standard deviation (PSD). Results: 75 eyes of 57 patients satisfied the inclusion criteria with an average follow–up of 7.3 ± 3.3 years. Eighty–one percent of patients were African–American. Average age was 72.1 ± 11.6 (range 43 to 89). All but 3 eyes started with 20/50 vision or better, and the mean baseline MD for all eyes was –20.15dB. Fourteen eyes lost more than three lines of visual acuity over the study period. Ten of these fourteen progressed to a visual acuity of 20/200 or worse. At no time during the study period did any patient have greater than a 5–decibel decrease in MD from baseline that could be reproduced over two consecutive visual fields. Compared to baseline, 4 eyes lost 5 degrees or more of visual field diameter by the end of the study period. One of these eyes also progressed to a visual acuity worse than 20/200. Conclusions: In this predominantly African–American population, the majority of treated patients with end–stage glaucoma did not suffer a decline in visual acuity or a progressive loss of the central visual field.
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