Prevalence, Features, and Severity of Glaucomatous Visual Field Loss Measured With the 10-2 Achromatic Threshold Visual Field Test.

PURPOSE

To investigate the clinical characteristics of 10-2 visual field defects in subjects with a diagnosis of glaucoma or glaucoma suspicion.

DESIGN

Prospective, observational cohort study.

METHODS

From participants enrolled in an ongoing glaucoma research study at our institution, we identified 354 eyes in 180 subjects (97 with primary open-angle glaucoma, 83 with glaucoma suspicion) who had 2 or more reliable 24-2 and 10-2 visual field tests and good-quality spectral-domain optical coherence tomography (SDOCT) scans. Eyes with macular pathology, significant cataract, or nonglaucomatous vision loss were excluded. We applied previously published cluster criteria to define 10-2 visual field loss, and then calculated prevalence, location, severity, and pattern of 10-2 visual field loss as well as its relationships with various functional and structural parameters.

RESULTS

Repeatable 10-2 visual field defects were present in 89 of 180 subjects (49%) and usually exhibited an arcuate or nasal pattern. In eyes with no, mild, moderate, and advanced 24-2 visual field loss, 15 of 236 (6%), 49 of 67 (73%), 25 of 26 (96%), and 25 of 25 (100%) had 10-2 visual field defects, respectively. Of the 114 eyes with 10-2 visual field loss, 93 (82%) demonstrated abnormal points within the central 10 degrees of the 24-2 visual field test. Mean defect on the 10-2 and 24-2 tests was highly correlated (r(2) = 0.72).

CONCLUSIONS

Although central VF loss appears to be common in glaucoma and may have an important role in glaucoma management, additional study is warranted to more definitively determine the optimal methods to detect presence, severity, and functional impact of central glaucomatous visual field loss.