How Well Do Visual Field Patterns Correspond Between Eyes of Glaucoma Suspects and Patients: Diagnostic Innovations in Glaucoma Study (DIGS)

Abstract

 

Abstract:

 

 

To determine the relationship between patterns of visual field (VF) loss on standard automated perimetry (SAP) in the right and left eyes of glaucoma suspects and patients.

 

164 eyes of 82 glaucoma suspects (by ophthalmic exam or intraocular pressure > 22 mmHg) and patients with glaucomatous optic neuropathy were included. Patients had 2 reliable, abnormal (pattern standard deviation p<5% or Glaucoma Hemifield Test "Outside Normal Limits") SAP visual fields within 1 year for each eye. Patterns of visual field loss were classified as arcuate, partial arcuate, nasal step, paracentral or normal based on Keltner et al. criteria by two independent masked graders based on the pattern deviation (PD) plot. Cases of disagreement were resolved by adjudication of a third grader. Only repeatably abnormal locations (PD p<5%) were considered part of the pattern. Superior and inferior hemifields were graded separately.

 

Results: Inter–grader agreement prior to adjudication (kappa±SE) was 0.86±0.04 (superior) and 0.89±0.04 (inferior). All patients had a defect in at least 1 hemifield of one eye. The percentage VF pattern correspondence was: 41% (superior–superior), 39% (inferior–inferior) and 19% (inferior–superior).

 

Patterns of VF loss between eyes correspond better within hemifields than between hemifields. The highest correspondence of VF pattern between eyes was a normal hemifield (superior or inferior), followed by an arcuate defect (superior hemifield). More severe patterns of VF loss (e.g., arcuate) may be likely to have symmetry as the disease advances in the less damaged eye.

 

 

 

Keywords: perimetry • visual fields