April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Long-Term Progression of Visual Field Defects in Patients With Primary Angle Closure Glaucoma Treated at one Singapore Hospital
Author Affiliations & Notes
  • V. T. Koh
    Singapore Eye Research Institute, Singapore, Singapore
  • D. T. Quek
    Singapore Eye Research Institute, Singapore, Singapore
    Singapore National Eye Centre, Singapore, Singapore
  • T. Aung
    Singapore Eye Research Institute, Singapore, Singapore
    Singapore National Eye Centre, Singapore, Singapore
  • Footnotes
    Commercial Relationships  V.T. Koh, None; D.T. Quek, None; T. Aung, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 3996. doi:
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      V. T. Koh, D. T. Quek, T. Aung; Long-Term Progression of Visual Field Defects in Patients With Primary Angle Closure Glaucoma Treated at one Singapore Hospital. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3996.

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

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Abstract

Purpose: : To investigate the long-term progression of visual field (VF) defects in treated primary angle closure glaucoma (PACG) patients based on the Advanced Glaucoma Intervention Study (AGIS) scoring system.

Methods: : Consecutive PACG patients presenting at a Singapore hospital with a follow-up duration of at least 10 years were retrospectively analyzed. All Humphrey visual fields (HVF, central 24-2 threshold test) performed during the follow-up period were reviewed and only reliable fields (fixation losses <20%, false positives and false negatives <33%) were scored using the AGIS system. Asymmetry in severity of VF defect was defined as an inter-ocular score difference of more than 4. Progression of a VF defect was defined as a score change of more than 4 from baseline on 2 consecutive HVF tests.

Results: : A total of 116 eyes of 69 subjects (56.5% female, 98.6% Chinese, mean age 62.3 years) were included. On average, each subject had 14±4.5 HVF tests over 10.5±2.4 years, 69.2% of which were reliable. At baseline, the mean AGIS score was 9.25±7.10 (moderate severity) and 43.2% of patients exhibited inter-ocular asymmetry. The mean score for the worse eye was 12.1±6.8 (severe) compared to 5.9±6.5 (moderate) in the fellow eye (p<0.001). Over the follow-up period, 43.9% of eyes were treated with topical anti-hypertensive medication, 67.2% had laser iridotomy and 79.3% had undergone glaucoma surgery. VF progression was detected in only 12 eyes (10.3%) of 10 patients, with a mean progression score of 6.2±2.2 over 7.2±3.6 years. Comparing patients who progressed with those that did not, there was no significant difference in age, gender, severity of baseline VF defect or type of treatment.

Conclusions: : PACG patients frequently present with VF defects of moderate severity and significant inter-ocular asymmetry. Over a 10-year period, only a small proportion of hospital-treated patients progressed in severity of VF defects

Keywords: visual fields • optic nerve 
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