Diffuse field loss and central visual function in glaucoma.
Eighty-two eyes of 82 patients with different types of glaucoma were examined with program 30-2 of the Humphrey Field Analyzer. Forty-six of 82 eyes (56.1%) had diffuse field loss and 36/82 (43.9%) eyes had no diffuse field loss according to the cumulative defect curves. Various foveal threshold criteria including temporal transfer and color vision were tested in all eyes. All criteria showed a loss of sensitivity in the presence of diffuse field loss. The loss of sensitivity was statistically significant for the high-frequency end of the foveal temporal contrast-sensitivity function (P = 0.0498), for foveal flicker-fusion frequency (P = 0.0275) and for foveal and parafoveal blue-on-yellow sensitivity (fovea: P = 0.0009; 4 parafoveal points: P = 0.0001; 16 points in the central 10 degrees: P < 0.0001). The loss in sensitivity was not statistically significant for the low and intermediate temporal frequencies of the foveal temporal contrast-sensitivity function and for the FM 100-Hue loss score. All temporal threshold criteria showed a low sensitivity (25-37%) and a low negative predictive value (48-50%) for the presence of diffuse field loss. Their specificity (75-94%) and positive predictive value (65-83%) are high, however. Thus, whenever one of the foveal temporal threshold criteria as used in the present study is abnormal, the probability is very high that there is some diffuse field loss.
Lachenmayr
B J
BJ
Department of Ophthalmology, University of British Columbia, Vancouver, Canada.
Drance
S M
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003118:Color Perception / Q000502:physiology; D015350:Contrast Sensitivity / Q000502:physiology; D005188:False Negative Reactions; D005260:Female; D005425:Flicker Fusion / Q000502:physiology; D005584:Fovea Centralis / Q000502:physiology; D005901:Glaucoma / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D014786:Vision Disorders / Q000473:pathology / Q000503:physiopathology*; D058609:Visual Field Tests; D014794:Visual Fields; D014796:Visual Perception / Q000502:physiology*