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S. A. Gandolfi, D. Paoli, P. Brusini, C. E. Traverso; Patterns of Glaucomatous Visual Field Defects and 5-20 Years Progression in a Cohort of 532 Eyes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3998. doi: https://doi.org/.
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(a) to test, in glaucomatous eyes, the prevalence of the visual field defect type according to the Brusini Glaucoma Staging System 2 , (b) to verify the mid-term and long-term patterns of visual field deterioration in glaucoma
the experimental data were sorted from the Glaucoma Management System 3 (GMS3) database of the Glaucoma Clinic of Monfalcone, Udine and Parma. A query asking for patients, bearing an unquestionable glaucomatous visual field defect on HFA (full threshold strategy), followed for at least 8 years was run. The program dissected out 49 eyes (mean follow up = 10.5 years, range 8-20 years, mean number of fields / patient = 11.8). Then a further query looking for patients followed for > 5 years and < 8 years was run. 483 eyes were dissected (mean follow up 5.3 years, mean number of fields / patient = 5.9, maen MD = - 6.32 dB, range 1,8 - -29.74, mean CPSD = 4,1 , range 0,51 - 15,21). The analysis of progression was performed by running the algorhytm Glaucoma Damage Probability Trend (GDPT), enclosed within the GMS3 and offering a trend analysis based upon regression vs time of (a) field indexes or (b) the GSS2 stage.
at the beginning of the follow up, 414 / 532 eyes (78%) laid within the frame of the "mixed" defects area. After 5 years, 238 eyes (45%) were still in the "mixed" defects area. In the longterm, 25 / 49 eyes (51%) still remained within the "mixed" defects area. GDPT showed a linear progression in 91% of those eyes remaining, in the mid-term as well as in the long-term, within the "mixed" defects area, meanwhile progression was linear in < 5% of those eyes either starting or ending outside the "mixed" defects area.
(a) the majority of eyes, bearing an unquestionable glaucomatous visual field defect, can be recovered within the frame of the "mixed defects" of the Brusini GSS2. (b) the 5 to 20 years pattern of field progression is linear only if the eye remains within the "mixed" defects area. Those eyes exiting the mixed defects area (or starting either in the "diffuse" or in the "localized" defect areas) show a non-linear (thus less predictable) progression pattern
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