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O. Thonginnetra, V. C. Greenstein, D. Chu, J. M. Liebmann, R. Ritch, D. C. Hood; Normal versus High Tension Glaucoma: A Comparison of Functional and Structural Deficits. Invest. Ophthalmol. Vis. Sci. 2008;49(13):744. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare visual field deficits measured with multifocal visual evoked potential (mfVEP) and Humphrey visual field (HVF) techniques to measurements of optic disc topography in patients with normal tension glaucoma (NTG) and high tension glaucoma (HTG).
Thirty patients with NTG and 32 with HTG were studied. All patients had reliable 24-2 HVFs with a mean deviation (MD) ≥-10 dB and a glaucomatous optic disc and an abnormal HVF (PSD and/or GHT) in at least one eye. Monocular mfVEPs were obtained from each eye using VERIS (EDI). The stimulus was a pattern-reversal dartboard. The mfVEP responses were analyzed with custom software and monocular probability plots were derived [1,2]. The mfVEP and HVF probability plots were divided into a central 10-deg. (radius) and an outer arcuate area in both hemifields. Cluster analyses and counts of abnormal points were performed in each sub-field [3,4]. Optic disc images were obtained with the Heidelberg Retina Tomograph III (HRT III) and divided into 6 segments. Segments were defined as abnormal compared to a normative database using Moorfields regression analysis.
There were no significant differences in MD and PSD values for NTG compared to HTG eyes. However, NTG eyes had a higher prevalence of cluster deficits in the central superior sub-field on both mfVEP and HVF. HTG eyes had a higher prevalence of cluster deficits in the inferior outer arcuate area for HVF. For HRT III there was no significant difference in total rim area, however the nasal segment was abnormal in significantly more HTG than NTG eyes (p<0.05) suggesting more peripheral damage in HTG in areas outside that measured by 24-2 HVF.
The combined visual field and HRT data suggest more localized and central deficits for NTG as compared to more peripheral and diffuse deficits for HTG. Ref: 1. Hood et al (2002) AO. 2. Hood and Greenstein (2003) Prog Ret Eye Res. 3. Goldberg et al (2002) AJO. 4. Hood et al (2003) J Glaucoma.
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