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J. V. Loman, D. Hoffman, D. Tran, T. Zien, S. Law, A. Coleman, J. Caprioli; Visual Field Progression in Glaucoma: Prevalence and Concordance of Visual Field Progression in Fellow Eyes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1639.
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To examine the prevalence of visual field progression in fellow eyes of patients with open-angle glaucoma and to identify similar locations of visual field progression.
Humphrey 24-2 visual fields from both eyes of open angle glaucoma patients were analyzed. Inclusion criteria included those diagnosed with open-angle glaucoma, had a mean deviation on initial visual field of ≥-15dB in the worse eye, ≥3.5 years of followup, and ≥8 reliable visual fields of both eyes. Exclusion criteria included those with other ocular pathology that affected visual field outcomes. Visual field progression (VFP) in patients with open angle glaucoma were identified with pointwise linear regression analysis. Progression of a test location was defined as a decrease of threshold sensitivity of ≤-1 dB/yr and a slope with p<0.01. The two-omitting algorithm was used. Progression was identified if at least two locations in the same Glaucoma Hemifield Test (GHT) cluster had progressed. In patients who had VFP in both eyes, the locations were compared.
288 patients met the inclusion criteria. Follow-up was 8.8(±3.08) yrs, number of visual fields analyzed per patient was 13.0(±4.62). Fifty-three (18.4%) patients had VFP in one or both eyes. Eleven (3.8%) patients had bilateral VFP. Of those that had bilateral progression, 10 patients (90.9%) had VFP in the same GHT location. VFP was distributed equally between inferior and superior GHT locations. Only one patient had bilateral VFP in both hemifields.
Glaucoma patients with bilateral visual field progression tend to worsen in concordant locations of the visual field. Visual field testing concentrated in these similar locations may help detect early progression in the fellow eye.
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