Abstract
Purpose: :
to describe the morphology, clinical implications and evolution of a specific type of glaucomatous perimetry pattern defined by us as "nasal wedge defect". We define it as the appearance of scotomata that begin in the periphery and extend rapidly and deeply towards the fixation point along the horizontal meridian.
Methods: :
retrospective analysis of 2.124 glaucoma visual fields (588 eyes from 313 patients) performed with an Octopus 101 perimeter (TOP strategy) from March 2001 to March 2007. Statistical analysis: description of the studied variables and diagnostic tools validation by receiver operating characteristic curves.
Results: :
12 eyes displayed a nasal wedge perimetric defect from initial to last stages of the disease and 17 eyes presented a classic concentric glaucomatous progression. The first group had a mean progression time of 5.41 years, 11.08 decibels (dB) inside the Bjerrum area in the initial visual fields and 82.08 dB at the last stage. The second group had 104.94 dB in the Bjerrum area initially and 444.82 dB at the final stage, with a mean progression time of 15.05 years. P< 0.0001. No statistically significant differences of intraocular pressure were found between both groups at any stage of the disease.
Conclusions: :
the detection of this wedge defect suggests a rapid, devastating glaucomatous progression in contrast with the classic concentric pattern of evolution.
Keywords: visual fields • intraocular pressure • perimetry