Patterns of glaucomatous visual field progression identified by three progression criteria.
OBJECTIVE
To determine typical patterns of repeatable glaucomatous visual field progression.


METHODS
Retrospective analysis of data obtained from two prospective studies.


METHODS
Included were 72 eyes of 72 patients tested up to six times over 2 years, and 40 eyes of 40 patients followed annually for up to 12 years. Each patient had two abnormal baseline visual fields, abnormal optic nerves, and serial fields. Progression was identified using three methods: by glaucoma change probability using total deviation (GCP-TD) and pattern deviation (GCP-PD) plots and by a clinical criteria. Progression was categorized as deepening or expansion of an existing scotoma, or a new scotoma.


RESULTS
The percentage of eyes repeatably progressed ranged from 17% to 27%. The most common pattern of progression was a deepening of an existing scotoma in the annual group, followed by expansion. With two follow-ups required, percentages for deepening only were 20% (clinical classifier). A combination of expansion and deepening was most common for the GCP criteria: 15% (GCP-TD classifier), and 10% (GCP-PD classifier) for the annual group. For the semiannual group, deepening was most common with the clinical criteria (11% of eyes), and deepening with expansion was most common by GCP criteria (14%, GCP-TD and GCP-PD). No eyes showed repeatable new scotomas.


CONCLUSIONS
Glaucomatous visual fields progress in the area of the visual field where baseline testing showed an existing scotoma. Follow-up testing might be improved by concentrating on already defective locations and using sparser test patterns or screening algorithms in normal areas of the visual field.
Boden
Catherine
C
Hamilton Glaucoma Center and Visual Function Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla, California 92093, USA. cboden@eyecenter.ucsd.edu
Blumenthal
Eytan Z
EZ
Pascual
John
J
McEwan
Gavin
G
Weinreb
Robert N
RN
Medeiros
Felipe
F
Sample
Pamela A
PA
D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D005902:Glaucoma, Open-Angle / Q000145:classification / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012607:Scotoma / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*