Inter-eye comparison of patterns of visual field loss in patients with glaucomatous optic neuropathy.
OBJECTIVE
To compare inter-eye patterns of visual field (VF) loss on standard automated perimetry (SAP) in patients with glaucomatous optic neuropathy.


METHODS
Observational cross-sectional study.


METHODS
Four-hundred-and-ninety eyes of 245 patients with glaucomatous optic neuropathy in at least one eye defined by masked stereophoto review were included. Patients had two reliable SAP visual fields within fifteen months for each eye. Patterns of visual field loss were classified independently by two graders masked to all other patient information. Patterns were described as altitudinal, arcuate, partial arcuate, paracentral, nasal step, temporal wedge, or normal based on the classification system of Keltner and associates. Superior and inferior hemifields were graded separately.


RESULTS
Inter-grader agreement in visual field patterns before adjudication was 97% and 94% for the worse eye (superior and inferior hemifield) and 97% and 95% for the better eye (superior and inferior hemifield). The percentage of correspondence by hemifield location was: 53% (superior-superior), 62% (inferior-inferior), 45% (superior-inferior), and 55% (inferior-superior). The highest correspondence of individual glaucomatous VF pattern between eyes was for arcuate (superior-superior) and inferior partial arcuate (inferior-inferior) defects (24% and 26%, respectively). Smaller hemifield patterns showed lower correspondence between the eyes (nasal step, paracentral, temporal wedge, 0% to 13% correspondence).


CONCLUSIONS
Patterns of visual field loss between eyes often corresponded within the same VF hemifield (superior-superior, inferior-inferior) as well as between opposite hemifields (inferior-superior), although opposite hemifield correspondence was less common. More advanced visual field defects (for example, partial arcuate) showed higher correspondence rates between the eyes than less advanced defects.
Hoffmann
Esther M
EM
Department of Ophthalmology, Hamilton Glaucoma Center, University of California of San Diego, La Jolla, California, USA.
Boden
Catherine
C
Zangwill
Linda M
LM
Bourne
Rupert R
RR
Weinreb
Robert N
RN
Sample
Pamela A
PA
D000368:Aged; D003430:Cross-Sectional Studies; D005189:False Positive Reactions; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011237:Predictive Value of Tests; D014786:Vision Disorders / Q000145:classification / Q000175:diagnosis*; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields