Abstract
Abstract: :
Background: The topography of Visual Field Loss (VFL) and the nerve fibre bundle defects are similar between Normal Tension Glaucoma (NTG) and Drusen of the Optic Disc (ODD). There are no controlled longitudinal studies that evaluate the Visual Field Progression (VFP) in ODD. Therefore this study tries to get indirect information on the time dynamic of VFP in ODD in comparison to NTG. Purposes: To evaluate: 1. The incidence and stage of VFL and the age of the patients at time of diagnosis in patients with uni– and bilateral ODDs. 2. The time difference in the mean age of patients between patients without VFL, patients with stage I and II and a group with stage III and IV of VFL in ODD and NTG. 3. The frequency of disease detection within age groups. Methods: 77 out of 90 patients met the inclusion criterias: reliable visual field examinations, no other disease which can cause a VFL. For comparison 115 patients with NTG with VFL up to stage IV were evaluated. According to the eye with the more severe VFL we categorised for both diseases 3 groups (1–3): 1.No VFL, 2.Beginning VFL (stage I and II, classification of Aulhorn), 3.Moderate VFL (stage III and IV). Results:ODD: Out of 90 patients 60% were femal 40% male, 4,4% had glaucoma, 2,2% NAION, 2,2% central vene occlusion. 76,7% had bilateral ODDs. 1. The incidence of VFL was 64 % (49 of 77 Patients). 2. ODD: 28 eyes/patients had no VFL and an average age at the time of diagnosis of 34,8 years and 32 eyes with VFL Stage I or II had an average age of 41,6 years. Time difference between groups: 6,8 years. 7 eyes/patients with VFL stage III or IV had an average age at diagnosis of 49,9 years. Time difference: 8,3 years. NTG: 35 eyes/patients with preperimetric NTG had an average age at the time of diagnosis of 50,2 years and 45 eyes/patients with VFL Stage I or II had an average age of 58,4 years. Time difference: 8,2 years. 35 eyes/patients with VFL stage III or IV had an average age at diagnosis of 59,4 years. Time difference: 1 year. The time between the preperimetric stage and VFL Stage I and II is shorter in ODD than NTG. 3. The frequency of disease detection was in ODD compared to NTG in the age group of up to 30 years 34,4% vs. 3,4% , in the age group from 31–40 12,2% vs. 11,6%, 41–50 13,3% vs. 19,1%, 51–60 18,9% vs. 24,5%, 61–70 14,4% vs. 24,5, 71–80 4,4% vs. 14,3%, 81–90 2,2% vs. 2,7% Conclusion: The results suggest that ODD has a faster VFP than NTG. Controlled longitudinal follow up studies are needed for ODD.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence