Rates of Visual Field Loss in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma: Asymmetric Patterns

• Published in: Investigative ophthalmology & visual science 2018-12, Vol.59 (15), p.5717-5725
• Main Authors: Yousefi, Siamak, Sakai, Hiroshi, Murata, Hiroshi, Fujino, Yuri, Matsuura, Masato, Garway-Heath, David, Weinreb, Robert, Asaoka, Ryo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Female; Glaucoma, Angle-Closure - diagnosis; Glaucoma, Angle-Closure - physiopathology; Glaucoma, Angle-Closure - surgery; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - physiopathology; Glaucoma, Open-Angle - surgery; Humans; Intraocular Pressure - physiology; Laser Coagulation; Male; Middle Aged; Nerve Fibers - pathology; Retinal Ganglion Cells - pathology; Retrospective Studies; Vision Disorders - physiopathology; Visual Field Tests; Visual Fields - physiology
• ISSN: 1552-5783; 1552-5783
• DOI: 10.1167/iovs.18-25140

The purpose of this study was to evaluate the rate of visual field (VF) loss in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Four hundred forty eyes of 282 patients with POAG (aged 53.4 ± 12.0: mean ± standard deviation, years) and 79 eyes of 49 patients with PACG (aged 62.7 ± 9.0 years) with at least six or more reliable VF tests were studied. Point-wise, region-wise, and global rates of VF change were assessed for POAG and PACG eyes. Only the VF records prior to laser iridotomy or cataract surgery were included in PACG eyes. The global and superior-inferior asymmetric rates of VF loss were compared between POAG and PACG eyes. The mean total deviation (mTD) values at baseline were -6.4 ± 5.7 dB in POAG patients and -6.4 ± 7.3 dB in PACG patients. There was not a significant difference in the progression rates of mTD between POAG eyes (-0.23 ± 0.38 dB/y) and PACG eyes (-0.29 ± 0.45 dB/y). In POAG eyes, the VF progression rate was significantly asymmetric across the horizontal line; the central, paracentral, and peripheral arcuate 2 regions in the superior hemifield had a significantly faster rate of VF loss than their inferior counterparts. In contrast, this asymmetry was not observed in the rate of VF loss in PACG eyes. POAG eyes showed a faster rate of VF loss in the superior hemifield compared to in the inferior hemifield, particularly in central and paracentral regions. This difference was not observed in PACG eyes.