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David B. Henson, Paul H. Artes, Balwantray C. Chauhan; Diffuse Loss of Sensitivity in Early Glaucoma. Invest. Ophthalmol. Vis. Sci. 1999;40(13):3147-3151.
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purpose. To establish whether there is significant diffuse loss of sensitivity
in a population of patients with early glaucoma.
methods. The differential light sensitivities at the 10 most sensitive locations
from within the central 24° of program 30-2 of the Humphrey Field
Analyzer (Humphrey Instruments, San Leandro, CA) were compared in 38
pairs of age-matched subjects, one of each pair with early primary
open-angle glaucoma (POAG) and the other with normal eyes. All subjects
had had experience with automated perimetry and had clear media, visual
acuity of 20/25 or better, and one or fewer false-positive or
false-negative responses to catch trials.
results. The mean difference in age between the subjects with glaucoma and
normal subjects was 29 days (P = 0.44, maximum 1.42
years). The mean paired difference in pupil size was 0.16 mm
(P = 0.26), and visual acuity was higher in the
glaucoma-affected subjects (P = 0.044). The 10
highest sensitivity measurements in the POAG-affected subjects were
found to be lower by a median of between 1.0 and 2.0 dB than those in
the normal pair members (0.0001 < P < 0.012,
sign test). In 60% of the pairs the sensitivity at the seventh most
sensitive location was 2 dB or more lower in the POAG-affected eyes.
conclusions. Early glaucomatous visual field loss frequently involves a diffuse
component that includes the 10 most sensitive locations. These findings
suggest that purely localized visual field loss in glaucoma is rare.
These observations could not be explained by factors of pupil size and
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