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Denise Pensyl, Michael Sullivan-Mee, My Tho Karin Tran, Grace Tsan, Suchitra Katiyar; Characteristics of glaucomatous central visual field loss as measured with the 10-2 testing pattern. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3902.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the prevalence and features of central visual field damage as measured with the 10-2 test in subjects with glaucoma or glaucoma suspicion.
All subjects were participating in a prospective, longitudinal glaucoma research study at the Albuquerque VA Medical Center in which routine 10-2 achromatic threshold visual field (VF) tests were added to the protocol in 2013. For inclusion, we required two or more reliable 24-2 and 10-2 VF tests, good quality circumpapillary retinal nerve fiber layer (RNFL) and macular thickness (MT) asymmetry scans obtained within 6 months of the VF tests, and a diagnosis of primary open-angle glaucoma (POAG), ocular hypertension (OH), or glaucoma suspect (GS). Eyes with macular pathology or significant cataract were excluded. After applying previously published cluster criteria1 to define 10-2 VF loss, we calculated prevalence of 10-2 VF defects (VFD) by subject and by eye. We then examined characteristics of 10-2 VFD including its features (location, severity, pattern) and its relationships with functional and structural elements (24-2VF, RNFL, MT parameters).
In 354 eyes of 180 subjects (97 POAG, 54 OH, 29 GS), we found repeatable 10-2 VFD in 89 (49%) subjects and 114 (32%) eyes. Location of 10-2 VFD was equally distributed by hemispheres (superior =44 eyes, inferior =45 eyes, both =25 eyes), but superior 10-2 VFD was deeper and closer to fixation than inferior 10-2 VFD (ANOVA, p<0.001). In eyes with mild, moderate, and advanced 24-2 VF loss, 49/67 (73%), 25/26 (96%), and 25/25 (100%) had concurrent10-2 VFD, respectively. Fifteen of 114 eyes (13%) had 10-2, but not 24-2, VF loss while 19/118 (16%) eyes had 24-2 VFD without 10-2 loss. Compared to eyes without 10-2 VFD, eyes with 10-2 VFD exhibited reduced global RNFL (64.4 vs. 86.4µm, p<0.001), reduced total MT (264.9 vs. 280.0µm, p<0.001), and higher intra-eye MT asymmetry (10.2 vs. 4.7µm, p<0.001).
Our results indicate that central VF loss is common in glaucoma, even when 24-2 VF loss is mild. Because the central field is critical to visual function, clinicians should consider 10-2 testing in glaucoma management, particularly in the setting of 24-2 VFD and abnormal RNFL or MT scans.1. Traynis et al. Prevalence and nature of early glaucomatous defects in the central 10° of the visual field. JAMA Ophthalmol 2014.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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