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Hyun-kyung Cho, Changwon Kee; Comparison of the Progression Rate of the Hemifield Corresponding to Superior, Inferior, and Both Hemifield RNFL Defect in Normal Tension Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):227.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the progression rate of the superior and inferior hemifield defect and each hemifield of both hemifield defect in normal tension glaucoma (NTG) patients and compare the progression rate of each hemifield between groups on the eyes with similar baseline hemifield defect.
Medical records of 142 NTG patients who performed more than 5 reliable standard visual field test with either superior (group 2, n=51) or inferior (group 1, n=44) or both hemifield (group 3, n=47) defects were retrospectively analyzed. The changes of mean thresholds of the 10 zones of the glaucoma hemifield test, the entire superior and inferior hemifield based on total deviation maps were inspected. Linear mixed effect model with unequal random effect variances was employed. Covariates such as age, gender, initial intraocular pressure, mean deviation (MD), pattern standard deviation (PSD), and visual field index were controlled.
The mean follow-up period was 8.19±3.30 year. There were no statistically significant differences in baseline characteristics including age, systemic and ocular factors between groups except for the female gender, which showed a statistically significant difference among the 3 groups (p=0.032). Initial MD and PSD were statistically significantly higher in group 3 than group 1 (all p=0.000) and group 2 (all p=0.000) but no statistically significant differences between group 1 and 2. There were no statistically significant differences in the initial mean thresholds of each hemifield between each group and between superior and inferior hemifield of group 3. The progression rate of group 2 was statistically significantly faster than group 1 (-0.7129dB/yr vs -0.5159dB/yr vs, p=0.0186), especially in central and nasal zones. The progression rate of group 2 was statistically significantly faster than superior hemifield of group 3 (-0.7165dB/yr vs -0.4698dB/yr, p=0.0014). There was no statistically significant difference in the progression rate between group 1 and the inferior hemifield in group 3 (-0.5078dB/yr vs -0.4413dB/yr, p=0.3120) and between superior and inferior hemifield in group 3 (-0.4680dB/yr vs -0.4423dB/yr, p=0.6622).
More careful examination and caution is required in the treatment of NTG patients with superior hemifield defect.
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