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Br J OphthalmolDecember 20234 citations

Accuracy of pattern deviation in estimating the glaucomatous damage in the central 10° visual field in eyes with glaucoma and cataract.

Tomita Ryo, Asaoka Ryo, Hirasawa Kazunori, Fujino Yuri, Nakakura Shunsuke, Murata Hiroshi, Omura Tetsuo, Shoji Nobuyuki, Obana Akira, Nishiguchi Koji M


AI Summary

This study found central 10° visual field pattern deviation can underestimate glaucoma damage as glaucoma progresses and overestimate it as cataract progresses, impacting clinical assessment.

Abstract

Background/aims: The accuracy of pattern deviation (PD) in estimating the damage to the glaucomatous visual field (VF) in the central 10° in eyes with glaucoma and cataract is unclear.

Methods

This retrospective study includes 63 eyes of 52 glaucoma patients who successfully underwent cataract surgery or cataract surgery plus iStent implantation. Using the Humphrey Field Analyser 10-2 test, VF was measured within 6 months preoperatively and postoperatively (VF pre and VF post , respectively). The mean total deviation values in VF post (mTD post ) indicates glaucomatous damage without cataract and the difference between this value and mean PD values in VF pre (mPD pre ) was evaluated (εmPD). The effect of cataract was then evaluated as the difference between mTD post and mTD pre (ΔmTD), while the effects of mTD post and ΔmTD on εmPD were also assessed. In addition, based on preoperative visual acuity (VA pre ) and VF pre , the optimal model for predicting mTD post was identified. The error of this method (εOptimalModel) was estimated as the difference against mTD post , which was compared with εmPD.

Results

Compared with mTD pre , there was a significant improvement in mTD post (p=0.028). A significant difference was observed between mPD pre and mTD post (p<0.001). Further, εmPD significantly increased with the increase of mTD post or ΔmTD (p<0.001 and p=0.0444, respectively). The absolute εOptimalModel was significantly smaller than the absolute εmPD (p<0.001).

Conclusions

This study warns clinicians that PD of the central 10° VF might underestimate the glaucomatous VF damage with the progression of glaucoma and overestimate it as a cataract progresses.


MeSH Terms

HumansVisual FieldsRetrospective StudiesVisual Field TestsGlaucomaCataractIntraocular Pressure

Key Concepts5

In eyes with glaucoma and cataract, pattern deviation (PD) of the central 10° visual field (VF) might underestimate the glaucomatous VF damage with the progression of glaucoma.

DiagnosisCohortRetrospective Cohort Studyn=63 eyes of 52 glaucoma patientsCh5Ch6Ch12Ch19

In eyes with glaucoma and cataract, pattern deviation (PD) of the central 10° visual field (VF) might overestimate glaucomatous VF damage as a cataract progresses.

DiagnosisCohortRetrospective Cohort Studyn=63 eyes of 52 glaucoma patientsCh5Ch6Ch12Ch19

The mean total deviation values in VF post-cataract surgery (mTD post) significantly improved compared with mean total deviation values in VF pre-cataract surgery (mTD pre) (p=0.028) in 63 eyes of 52 glaucoma patients who underwent cataract surgery or cataract surgery plus iStent implantation.

PrognosisCohortRetrospective Cohort Studyn=63 eyes of 52 glaucoma patientsCh6Ch44Ch45

A significant difference was observed between mean pattern deviation values in VF pre-cataract surgery (mPD pre) and mean total deviation values in VF post-cataract surgery (mTD post) (p<0.001) in 63 eyes of 52 glaucoma patients who underwent cataract surgery or cataract surgery plus iStent implantation.

DiagnosisCohortRetrospective Cohort Studyn=63 eyes of 52 glaucoma patientsCh6Ch44Ch45

The absolute error of an optimal model (εOptimalModel) for predicting mTD post-cataract surgery was significantly smaller than the absolute error of mean pattern deviation (εmPD) (p<0.001) in 63 eyes of 52 glaucoma patients who underwent cataract surgery or cataract surgery plus iStent implantation.

DiagnosisCohortRetrospective Cohort Studyn=63 eyes of 52 glaucoma patientsCh6Ch44Ch45

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